CPT 76817Radiology

Transvaginal us obstetric

CPT code 76817 covers a transvaginal ultrasound performed during pregnancy to examine the developing baby, placenta, and uterus using a specialized probe inserted into the vagina. This internal imaging provides clearer, more detailed views than abdominal ultrasound, especially in early pregnancy.

Showing rates for

National Average

Base Medicare rate

$88.95

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.75

PE RVU (NF)

1.96

MP RVU

0.04

Total RVU

2.75

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document whether study was performed transvaginally, transabdominally, or both; if both approaches used in same session, bill only 76817 if transvaginal was primary/definitive method
Impact: Prevents downcoding to 76801/76805 or duplicate payment denials; ensures correct $88.95 reimbursement
Verify the study includes all required elements for complete examination: uterus, adnexa, gestational sac measurements, embryo/fetal number, cardiac activity assessment, and any visible fetal anatomy appropriate to gestational age
Impact: Incomplete documentation may result in denial or request for 52 modifier with 50% payment reduction to $44.48
Do not bill 76817 with transabdominal obstetric ultrasound codes (76801, 76805, 76811, 76815) for the same examination session unless clearly distinct indications documented
Impact: Bundling edits will deny second code; improper unbundling can trigger fraud investigation
For cervical length assessment in addition to routine obstetric survey, document separately but recognize 76817 includes evaluation of visible cervix; dedicated cervical length (76815) may be separately billable only with distinct medical necessity
Impact: Improper separate billing of 76815 with 76817 results in bundling denial; proper documentation supports add-on when appropriate
Bill global code 76817 when both performing and interpreting in your facility; split with 26/TC modifiers only when technical and professional services are genuinely separate entities
Impact: Incorrect modifier usage reduces payment or creates compliance issues; global payment of $88.95 vs. split components
Ensure permanent images are stored and interpretation report includes all required elements with physician signature on date of service

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 76817 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 76817 is $88.95 for both facility and non-facility settings. This is based on 2.75 total RVUs (0.75 work RVU, 1.96 practice expense RVU, 0.04 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

When should I use CPT 76817 instead of 76801 for obstetric ultrasound?

Use CPT 76817 when the primary or definitive imaging is performed transvaginally (with probe inserted into vagina) rather than transabdominally (through the abdomen). Code 76801 is for transabdominal real-time obstetric ultrasound in first trimester. If both approaches are used in the same session, bill only the approach that provided the definitive diagnostic information, typically 76817 in early pregnancy.

Can I bill both CPT 76817 and 76815 together for cervical length measurement?

Billing both codes together requires careful documentation of medical necessity. CPT 76817 includes visualization of the cervix during routine transvaginal obstetric ultrasound. Code 76815 (cervical length) should only be billed separately when there is a distinct medical indication for detailed cervical assessment beyond the routine survey, with modifier 59 and clear documentation supporting the separate service.

What documentation is required to bill CPT 76817 and avoid audit denials?

Required documentation includes: indication for exam, technique (confirming transvaginal approach), uterus and adnexal description, gestational sac measurements and location, embryo/fetal number and measurements, cardiac activity assessment, yolk sac when visible, cervix when visualized, placental location when identifiable, permanent stored images, and physician interpretation with signature and date. Missing any required elements risks denial or recoupment.

How many RVUs is CPT code 76817 worth in 2025?

CPT 76817 has 2.75 total RVUs in 2025, consisting of 0.75 work RVUs, 1.96 practice expense RVUs (both facility and non-facility), and 0.04 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Should I use modifier 26 or TC when billing CPT 76817?

Use modifier 26 (professional component) when billing only for physician interpretation if the equipment and technical staff are employed by a separate facility. Use modifier TC (technical component) when billing only for equipment, supplies, and technical staff if a separate physician provides interpretation. Bill the global code without modifiers when your practice performs both technical and professional services.

What is the difference between CPT 76817 and 76830 for transvaginal ultrasound?

CPT 76817 is specifically for transvaginal obstetric ultrasound performed during pregnancy to evaluate the fetus, gestational sac, and pregnancy-related structures. CPT 76830 is for transvaginal ultrasound of non-pregnant pelvic structures (uterus, ovaries, adnexa) performed for gynecologic rather than obstetric indications. The clinical context and pregnancy status determine the appropriate code.