76815 Ultrasound
CPT 76815: Limited Obstetric UltrasoundLimited Obstetric Ultrasound
The short answer
Use 76815 for a limited obstetric ultrasound that answers one or a few focused questions: fetal heart rate, presentation, amniotic fluid, or placental location. It is reported once per encounter regardless of the number of fetuses, and it is the wrong code when the study reassesses a previously seen finding, which is follow-up code 76816.
Source: NCCISource: CMS MPFS 2026Source: ACOG/SMFM
When to use 76815
Report 76815 for the quick look: confirming viability in triage, checking presentation before delivery, a fluid check, or locating the placenta. The defining feature is scope, the study answers a specific clinical question without a complete survey. If the visit re-evaluates something already imaged, growth, fluid trending, or a finding under surveillance, use 76816 instead. Unlike most OB ultrasound codes, 76815 has no additional-fetus add-on; one unit covers the encounter no matter how many fetuses are scanned.
When to use 76815 vs 76816
76815 · Limited
- New focused question, first look
- Viability, presentation, fluid, placenta
- Once per encounter, any fetus count
- No prior study being reassessed
76816 · Follow-up
- Reassessing a known finding or growth
- Interval change is the question
- Per fetus, modifier 59 for additional
- A prior study is on file
Documentation checklist
A limited study needs a limited report, but not an empty one. Document the question asked and the answer found; a report that reads like a complete survey invites recoding questions in both directions.
✓ The specific clinical question stated as the indication
✓ Findings limited to the elements evaluated
✓ Fetal heart rate or viability where that was the question
✓ Presentation, fluid, or placental location as applicable
✓ Fetal number noted
✓ Images stored for the elements examined
✓ Signed interpretation with a focused impression
Global package rules
76815 is billed outside the global obstetric package and separately from 59400, even when performed in the office during a routine prenatal visit. It is reported once per encounter regardless of fetal number, and it should not be reported alongside a complete scan of the same anatomy on the same day; the limited study bundles into the complete one. NCCI
TC-26 components
Office-based OB practices usually own the machine and bill globally. Split the components only when interpretation and equipment belong to different entities: modifier 26 for the reading, TC for the facility.
76815 Global: one entity owns equipment and interpretation
76815-26 Professional: interpretation only
76815-TC Technical: equipment and technologist
Reimbursement
2026 · national Medicare averages | Component | Work RVU | Total RVU | 2026 rate |
|---|
| 76815Global | 0.63 | 2.44 | $81.50 |
| 76815-26Professional | 0.63 | 0.92 | $30.73 |
| 76815-TCTechnical | 0.00 | 1.52 | $50.77 |
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 a same-day complete scan
Why it happens
76815 was billed with 76801, 76805, or 76811 for the same session, and the limited study is a component of the complete one.
How to fix
Bill only the complete study when both occur in one session. A genuinely separate limited scan later the same day needs distinct documentation and a distinct-service modifier.
Source: NCCI CO-151 Frequency limit hit
Why it happens
Repeated 76815 claims across the pregnancy exceeded the payer's limit for limited scans without documented necessity.
How to fix
Each limited study needs its own indication. If the scans are surveillance of a known finding, they are 76816, which payers expect for serial imaging.
Source: CMS CO-16 Multiple units billed for twins
Why it happens
Two units of 76815 were billed for a twin pregnancy, but the code is once per encounter regardless of fetal number.
How to fix
Rebill one unit. The multiple-fetus add-on structure applies to complete and follow-up scans, not the limited study.
Source: NCCI CO-50 No focused indication documented
Why it happens
The claim lacked a clinical question, reading as a routine reassurance scan the payer does not cover.
How to fix
Link the ICD-10 code for the presenting question, decreased fetal movement, size-dates discrepancy, or bleeding, and make sure the report states it.
Source: ACOG/SMFM FAQ
What is the CPT code description for 76815?
In plain language, 76815 covers a limited obstetric ultrasound focused on one or a few specific questions, such as fetal heart rate, presentation, amniotic fluid volume, or placental location. It is a quick, targeted look rather than a complete survey.
How many units of 76815 do I bill for twins?
One. The code is defined per encounter, one or more fetuses, so fetal number does not change the units. This is the opposite of the complete-scan codes, which use per-fetus add-ons.
When is 76816 the better code?
When the study reassesses something already imaged: interval growth, fluid trending, or surveillance of a known finding. 76815 is a first look at a new focused question; 76816 is the follow-up.
Can I bill 76815 with a complete scan on the same day?
Not for the same session. The limited study bundles into the complete one. A separate medically necessary limited scan later the same day, such as a triage recheck, needs its own documentation and a distinct-service modifier.
Can 76815 be billed during a routine prenatal visit?
Yes, when there is a documented indication. The scan is separately payable from both the E/M or global prenatal care and 59400, but a no-indication reassurance scan is a common denial.
Does a bedside scan in labor triage count as 76815?
Usually, when a focused question like presentation or fluid is answered and documented with stored images and an interpretation. Without a stored image and a signed read, there is no billable study.
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.