Reviewed by certified coders + a maternal-fetal medicine physician / Updated for 2026
OB Coding Guide
OB Coding Guide
obcodingguide.com/codes/76805/
Clinical review: Sina Haeri, MD, MHSA (MFM) · Coder review pending · Drafted July 2026
76805 Ultrasound
CPT 76805

CPT 76805: Standard Fetal Anatomy UltrasoundStandard Fetal Anatomy Ultrasound

The short answer

Use 76805 for the complete standard anatomy ultrasound of a pregnancy at 14 weeks or later, most commonly the 18 to 22 week anatomy scan. It is billed outside the global obstetric package and is typically paid once per pregnancy. When the pregnancy is high-risk and a detailed anatomic survey is performed, report 76811 instead.

Source: NCCISource: CMS MPFS 2026Source: ACOG/SMFM

When to use 76805

Report 76805 for the routine complete anatomy survey after the first trimester: fetal biometry, a standard pass through the anatomic checklist, amniotic fluid, and placental location. This is the default anatomy scan for a low-risk pregnancy. It is not the code for a quick growth or fluid check, that is 76815 or 76816, and it is not the code for the deeper high-risk survey, that is 76811. For twins, add 76810 per additional fetus.

When to use 76805 vs 76811
76805 · Standard
  • Routine second-trimester survey
  • Low-risk baseline anatomy scan
  • No high-risk indication on file
  • Lower RVUs, standard documentation
76811 · Detailed
  • High-risk pregnancy or prior anomaly
  • Abnormal or unclear standard scan
  • Referral for targeted evaluation
  • Higher RVUs, once per pregnancy

Documentation checklist

A complete 76805 has a defined element list. If a required structure could not be visualized, say so and why; an element silently missing reads as an incomplete study and invites a downcode to 76815.

✓ Gestational age of 14 weeks or more established
✓ Fetal number and presentation
✓ Cardiac activity documented
✓ Standard biometry: BPD, head and abdominal circumference, femur length
✓ Survey of the standard anatomic checklist, with non-visualized structures explained
✓ Amniotic fluid assessment
✓ Placental location and appearance
✓ Evaluation of the maternal uterus, cervix, and adnexa when visible
✓ Images stored and a signed interpretation on file

Global package rules

76805 is billed separately from the global obstetric package; it is never bundled into 59400. Most payers cover one standard anatomy scan per pregnancy, so repeat imaging for growth or a recheck of a specific finding should go out as 76816, not a second 76805. For multiple gestations, report 76805 for the first fetus and 76810 for each additional fetus. NCCI

TC-26 components

When interpretation and equipment belong to different entities, split the code: the reading physician bills 76805 with modifier 26 and the facility bills 76805-TC. One entity doing both bills the global code, and only that entity.

76805
Global: one entity owns equipment and interpretation
76805-26
Professional: interpretation only
76805-TC
Technical: equipment and technologist

Reimbursement

2026 · national Medicare averages
ComponentWork RVUTotal RVU2026 rate
76805Global0.974.07$135.94
76805-26Professional0.971.41$47.10
76805-TCTechnical0.002.66$88.85

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 the global OB package
Why it happens
The payer applied global-package logic to an ultrasound, usually a claims-system edit rather than actual policy.
How to fix
OB ultrasounds are excluded from the global package. Appeal with the NCCI guidance showing 76805 is separately reportable from 59400.
Source: NCCI
CO-151 More than one anatomy scan per pregnancy
Why it happens
A second 76805 was billed when the payer covers one complete anatomy survey per pregnancy.
How to fix
Bill follow-up imaging as 76816. If a true repeat complete survey was needed, document the new indication and appeal with records.
Source: CMS
CO-236 76805 and 76811 reported same day
Why it happens
A standard and a detailed anatomy scan were both billed for the same fetus on the same date.
How to fix
Report one or the other. A detailed survey subsumes the standard scan; bill 76811 alone when the detailed exam was performed.
Source: NCCI
CO-16 Missing or invalid TC-26 modifier
Why it happens
The professional and technical components were billed without modifiers, or two entities both billed the global code.
How to fix
Split the claim correctly: 76805-26 for the interpretation, 76805-TC for the facility. Resubmit with the corrected modifiers.
Source: CMS
CO-50 Incomplete study billed as complete
Why it happens
The report did not document the full anatomic survey, so the payer treated the study as limited.
How to fix
If the survey was complete, appeal with the full report. If elements were genuinely not evaluated, rebill as 76815 and tighten the scanning protocol.
Source: ACOG/SMFM

FAQ

What is the CPT code description for 76805?
In plain language, 76805 covers the complete standard ultrasound of a pregnancy at 14 weeks or later: biometry, a full pass through the standard fetal anatomic checklist, amniotic fluid, and placental assessment. It is the routine anatomy scan for the first or only fetus.
How is 76805 different from 76811?
76805 is the standard anatomy survey for any pregnancy. 76811 is a detailed, high-risk anatomic evaluation with a longer element list, more documentation, and higher RVUs. The clinical indication and the depth of the survey drive the choice, not the equipment.
Can 76805 be billed more than once per pregnancy?
Usually not. Most payers cover one complete anatomy scan; later growth checks or rechecks of a specific finding belong under 76816. A repeat 76805 needs a new documented indication and often still denies on frequency.
What if the anatomy scan is incomplete because of fetal position?
If required elements could not be visualized despite a reasonable attempt, document that and the reason. Many practices still report 76805 with the limitation noted, but some payers expect 76815 for a substantially incomplete survey and 76816 for the completion visit. Check the payer's policy.
How do I bill the anatomy scan for twins?
76805 for the first fetus plus one unit of 76810 for each additional fetus, with biometry and anatomy documented per fetus.
Is 76805 part of the global OB package?
No. Obstetric ultrasounds are separately payable and are not bundled into 59400, regardless of who provides the prenatal care.
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.