76811 Ob us detailed sngl fetus
What 76811 is
CMS fee schedule short descriptor: Ob us detailed sngl fetus.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 76811 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.85 | 3.49 | 0.11 | 5.45 | $182.03 |
| Facility (hospital, ASC) | 1.85 | 3.49 | 0.11 | 5.45 | $182.03 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 76811 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 76811? These codes are bundled into it
76811 is a Column 1 code in 25 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0689T | Quan us tis charac w/o dx us | 1 - modifier may bypass | Check pair |
0690T | Quan us tis charac w/dx us | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
51701 | Insert bladder catheter | 1 - modifier may bypass | Check pair |
51702 | Insert temp bladder cath | 1 - modifier may bypass | Check pair |
76801 | Ob us < 14 wks single fetus | 0 - no modifier bypass | Check pair |
76805 | Ob us >/= 14 wks sngl fetus | 0 - no modifier bypass | Check pair |
76815 | Ob us limited fetus(s) | 0 - no modifier bypass | Check pair |
76816 | Ob us follow-up per fetus | 0 - no modifier bypass | Check pair |
76830 | Transvaginal us non-ob | 0 - no modifier bypass | Check pair |
76831 | Echo exam uterus | 0 - no modifier bypass | Check pair |
76856 | Us exam pelvic complete | 0 - no modifier bypass | Check pair |
76857 | Us exam pelvic limited | 0 - no modifier bypass | Check pair |
76941 | Echo guide for transfusion | 1 - modifier may bypass | Check pair |
76942 | Echo guide for biopsy | 1 - modifier may bypass | Check pair |
76998 | Us guide intraop | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99446 | Ntrprof ph1/ntrnet/ehr 5-10 | 0 - no modifier bypass | Check pair |
99447 | Ntrprof ph1/ntrnet/ehr 11-20 | 0 - no modifier bypass | Check pair |
99448 | Ntrprof ph1/ntrnet/ehr 21-30 | 0 - no modifier bypass | Check pair |
99449 | Ntrprof ph1/ntrnet/ehr 31/> | 0 - no modifier bypass | Check pair |
99451 | Ntrprof ph1/ntrnet/ehr 5/> | 0 - no modifier bypass | Check pair |
99452 | Ntrprof ph1/ntrnet/ehr rfrl | 0 - no modifier bypass | Check pair |
G0471 | Ven blood coll snf/hha | 1 - modifier may bypass | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.