CPT 76945Radiology

Echo guide villus sampling

CPT code 76945 covers ultrasound guidance used during chorionic villus sampling (CVS), a prenatal test where a doctor uses real-time ultrasound imaging to safely guide a needle or catheter to collect placental tissue for genetic testing.

Showing rates for

National Average

Base Medicare rate

$30.41

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

0.67

PE RVU (NF)

0.26

MP RVU

0.01

Total RVU

0.94

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

NCCI bundling edits

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Billing tips

Always bill 76945 in conjunction with the primary CVS procedure code (59015 for transcervical or 59012 for transabdominal approach)
Impact: Failure to bill this imaging guidance code results in lost revenue of $30.41 per procedure, potentially thousands annually for high-volume practices
Document continuous real-time ultrasound guidance throughout the entire CVS procedure, not just preliminary localization
Impact: Inadequate documentation of continuous guidance is the leading cause of denials; proper documentation ensures full reimbursement and withstands audits
Retain permanent images showing needle/catheter placement and document in the procedure report that ultrasound was used for real-time guidance
Impact: Image retention is often required for payment and critical during audits; missing images can trigger recoupment of the $30.41 payment
Verify that 76945 is not bundled into the global CVS payment by specific payers before billing separately
Impact: Some commercial payers bundle imaging into the procedure code; checking contracts prevents claim rejections and reduces accounts receivable days
Bill 76945 with the date of service matching the CVS procedure, not the date of any preliminary diagnostic ultrasound
Impact: Date mismatches trigger automatic denials; correct dating ensures clean claims and faster payment of the $30.41 reimbursement
Ensure the rendering provider for 76945 matches the physician performing the CVS, as this is guidance during the procedure
Impact: Provider mismatches can trigger fraud alerts or denials; correct attribution ensures compliant billing and avoids audit flags

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 76945 in 2025?

The 2025 Medicare national average reimbursement for CPT 76945 is $30.41 for both facility and non-facility settings. This is based on a total RVU of 0.94 (0.67 work RVU, 0.26 practice expense RVU, 0.01 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76945 be billed separately from the CVS procedure code?

Yes, CPT 76945 is separately reportable when real-time ultrasound guidance is provided during chorionic villus sampling. It should be billed in addition to the primary CVS procedure codes (59012 for transabdominal or 59015 for transcervical approach), provided documentation supports continuous guidance throughout the procedure.

What documentation is required to bill CPT 76945?

Required documentation includes a statement that real-time ultrasound guidance was used continuously throughout the CVS procedure, permanent images showing needle or catheter placement, description of visualized anatomic structures, and confirmation that guidance facilitated safe sampling. The physician performing the procedure must sign the imaging report.

How many RVUs is CPT code 76945 worth?

CPT code 76945 has a total RVU value of 0.94 for 2025, consisting of 0.67 work RVUs, 0.26 practice expense RVUs (both facility and non-facility), and 0.01 malpractice RVUs according to the CMS Physician Fee Schedule.

What is the difference between 76945 and a diagnostic obstetric ultrasound?

CPT 76945 represents real-time ultrasound guidance performed during the CVS procedure itself to visualize needle/catheter placement, while diagnostic obstetric ultrasounds (76801, 76805, 76811) are comprehensive fetal assessments performed separately. The guidance code 76945 is specifically for concurrent procedural visualization, not diagnostic evaluation.

Do I need modifier 26 or TC when billing 76945?

Modifiers 26 (professional component) and TC (technical component) are rarely needed for 76945 because the code has identical facility and non-facility rates ($30.41), suggesting it is typically billed as a global service. These modifiers would only apply in unusual split-billing arrangements between different entities.

Why would CPT 76945 be denied by insurance?

Common denial reasons include: documentation showing only preliminary imaging rather than continuous real-time guidance, missing permanent images, bundling edits that incorrectly include imaging in the CVS procedure payment, or date of service mismatches. Each denial type requires specific documentation in appeals to demonstrate the separate, medically necessary imaging service.