Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
OB Coding Guide
obcodingguide.com/codes/76801/
Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
76801 Ultrasound
CPT 76801

CPT 76801: First Trimester Obstetric UltrasoundFirst Trimester Obstetric Ultrasound

The short answer

Use 76801 for a complete transabdominal obstetric ultrasound performed before 14 weeks gestation. It covers the full first trimester survey: fetal number, cardiac activity, crown-rump length dating, and evaluation of the uterus and adnexa. For twins add 76802 per additional fetus, and once the pregnancy reaches 14 weeks the complete scan becomes 76805 instead.

Source: NCCISource: CMS MPFS 2026Source: AIUM

When to use 76801

Report 76801 for the first complete transabdominal scan of a pregnancy under 14 weeks: confirming an intrauterine pregnancy, dating by crown-rump length, or working up first trimester bleeding when a full survey is completed. The scan must be complete for gestational age; a quick viability check without the full survey is 76815, and a study done primarily or entirely transvaginally is 76817. The 14-week line is the whole game here, so anchor the gestational age in the report.

When to use 76801 vs 76805
76801 · First trimester
  • Gestational age under 14 weeks
  • Crown-rump length is the dating measure
  • Fetal number, cardiac activity, uterus, adnexa
  • Add 76802 for each additional fetus
76805 · 14 weeks and later
  • Gestational age 14 weeks or more
  • Full anatomic survey required
  • Biometry replaces crown-rump length
  • Add 76810 for each additional fetus

Documentation checklist

A complete first trimester study has a defined element list, and payers audit against it. The report should show all elements were evaluated or note why one could not be seen.

✓ Gestational age under 14 weeks established in the record
✓ Number of gestational sacs and fetuses
✓ Fetal cardiac activity documented
✓ Crown-rump length measurement and assigned dating
✓ Evaluation of the uterus, cervix, and adnexa
✓ Qualitative amniotic fluid assessment where visible
✓ Images permanently stored and retrievable
✓ Signed interpretation with findings and impression

Global package rules

Obstetric ultrasounds sit outside the global obstetric package, so 76801 is billed separately from 59400 even when the same practice provides all prenatal care. Most payers expect one complete first trimester scan per pregnancy; later studies use 76815, 76816, or the second trimester codes rather than a repeat 76801. NCCI

TC-26 components

Split the service when one entity interprets and another owns the equipment. The interpreting physician bills 76801 with modifier 26, the facility bills 76801-TC, and the unmodified global code is reserved for a practice that provides both components.

76801
Global: one entity owns equipment and interpretation
76801-26
Professional: interpretation only
76801-TC
Technical: equipment and technologist

Reimbursement

2026 · national Medicare averages
ComponentWork RVUTotal RVU2026 rate
76801Global0.973.50$116.90
76801-26Professional0.971.39$46.43
76801-TCTechnical0.002.11$70.48

National amounts under the 2026 Medicare Physician Fee Schedule (non-facility total RVU x $33.4009 conversion factor, no locality/MAC adjustment). Commercial and Medicaid rates differ. Verify current values with your MAC before billing.

Common denials

CO-97 Bundled into another same-day service
Why it happens
The payer treated 76801 as included in the global OB package or in another same-day ultrasound.
How to fix
OB ultrasounds are separately payable outside the global package. If a transvaginal study was also performed, report 76817 as a distinct approach and appeal with the NCCI rationale.
Source: NCCI
CO-151 Frequency exceeded for the pregnancy
Why it happens
More than one complete first trimester scan was billed and the payer's policy allows one per pregnancy.
How to fix
Recode follow-up studies as 76815 or 76816 as clinically appropriate, or document the new indication that required a repeat complete study.
Source: CMS
CO-50 Not medically necessary
Why it happens
The claim lacked a covered indication, often a routine-screening diagnosis a payer does not cover in the first trimester.
How to fix
Link the supporting ICD-10 code for the clinical indication, such as dating discrepancy, bleeding, or pain, and confirm the payer's screening policy.
Source: CMS
CO-16 Missing or invalid TC-26 modifier
Why it happens
Component billing was expected but the claim carried no modifier, or both entities billed the global code.
How to fix
Bill 76801-26 for the interpretation and let the equipment owner bill 76801-TC. Only one entity may bill the global code.
Source: CMS
CO-236 Incompatible with a same-day code
Why it happens
76801 was reported with 76815 or another overlapping scan for the same session.
How to fix
Report the complete study alone. A limited scan on the same day by the same provider is bundled into the complete exam.
Source: NCCI

FAQ

What is the CPT code description for 76801?
In plain language, 76801 covers a complete transabdominal obstetric ultrasound of a pregnancy under 14 weeks: counting fetuses, confirming cardiac activity, measuring crown-rump length for dating, and surveying the uterus and adnexa. It is the first-fetus code; additional fetuses get 76802.
What is the cutoff between 76801 and 76805?
Fourteen weeks zero days. Under 14 weeks, the complete scan is 76801. At 14 weeks or later it is 76805, which requires a full anatomic survey. Document the gestational age so the code choice is defensible.
Can I bill 76801 and 76817 on the same day?
Yes, when both a complete transabdominal study and a transvaginal study are performed and separately documented. They are different approaches, not duplicates, though some payers want modifier 59 on the second study.
How many times can 76801 be billed in a pregnancy?
Generally once. Later scans in the first trimester are usually limited (76815) or follow-up (76816) studies. A second complete scan needs a new, documented indication and still may hit frequency edits.
How do I bill 76801 for twins?
Report 76801 for the first fetus and add-on code 76802 for each additional fetus, with findings documented per fetus. 76802 goes on the same claim without modifier 51.
Does 76801 include the nuchal translucency measurement?
No. Nuchal translucency screening is its own study, 76813, with its own credentialing requirements. When both a complete first trimester scan and an NT study are performed and documented, both can be reported, subject to payer policy.
CPT® is a registered trademark of the American Medical Association. Educational reference only, not billing, legal, or medical advice. Maintained by Ouma Health, a maternal-fetal telemedicine practice. Printed from obcodingguide.com, content current as of July 2026.