76817 Ultrasound

CPT 76817

CPT 76817: Transvaginal Obstetric UltrasoundTransvaginal Obstetric Ultrasound

The short answer

Use 76817 for an obstetric ultrasound performed transvaginally: early pregnancy evaluation, cervical length assessment, or clarifying placental location. It can be billed in addition to a transabdominal study performed the same day, because the two approaches are separately reportable when each is documented. For a non-pregnant patient the transvaginal code is 76830.

Source: NCCISource: CMS MPFS 2026Source: AIUM

When to use 76817

Report 76817 whenever the study is performed with a transvaginal probe on a pregnant patient. The common scenarios are very early pregnancy where the transabdominal view is insufficient, cervical length surveillance in patients at risk for preterm birth, and pinning down a low-lying placenta or previa. When a transabdominal study, complete or limited, is performed at the same visit and separately documented, both are reportable; the transvaginal exam is a distinct approach, not a second look at the same study.

When to use 76817 vs 76830

76817 · Pregnant

Patient is pregnant, any trimester
Early pregnancy, cervix, or placenta
Reportable with same-day transabdominal
OB diagnosis codes on the claim

76830 · Non-pregnant

Gynecologic transvaginal exam
Pelvic pain, bleeding, masses
Never on a claim for a pregnant patient
GYN diagnosis codes on the claim

Documentation checklist

The report needs to make the approach and the reason for it obvious, especially when a transabdominal study is billed the same day.

✓ Transvaginal approach explicitly stated

✓ Indication documented: early pregnancy, cervical assessment, or placental localization

✓ Findings for the structures evaluated, cervical length measured where that is the question

✓ If a same-day transabdominal study was done, separate findings for each approach

✓ Fetal number and cardiac activity where applicable

✓ Images stored for the transvaginal exam specifically

✓ Signed interpretation with impression

Global package rules

76817 is billed outside the global obstetric package and separately from 59400. It carries no per-fetus add-on; one unit covers the exam. When billed with a same-day transabdominal study such as 76801, 76805, or 76815, each study needs its own documentation, and some payers want modifier 59 on the second approach even though NCCI permits the pair. Serial cervical length checks are repeat 76817 claims, each with the preterm-birth-risk indication attached. NCCI

TC-26 components

Split the components when interpretation and equipment ownership diverge: modifier 26 for the professional read, TC for the facility. Office OB practices scanning with their own probe bill the global code.

76817

Global: one entity owns equipment and interpretation

76817-26

Professional: interpretation only

76817-TC

Technical: equipment and technologist

Reimbursement

2026 · national Medicare averages

Component	Work RVU	Total RVU	2026 rate
76817Global	0.73	2.78	$92.85
76817-26Professional	0.73	1.06	$35.40
76817-TCTechnical	0.00	1.72	$57.45

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 Denied as duplicate of the transabdominal scan

Why it happens

The payer treated the same-day transvaginal exam as part of the transabdominal study.

How to fix

The approaches are separately reportable when each is documented. Append modifier 59 to 76817 per the payer's preference and appeal with both reports.

Source: NCCI

CO-236 76817 billed with 76830

Why it happens

The OB and GYN transvaginal codes were both reported for one exam.

How to fix

Pick one based on pregnancy status. A pregnant patient's transvaginal exam is 76817 only.

Source: NCCI

CO-151 Serial cervical length checks hit a frequency screen

Why it happens

Repeat 76817 claims for cervical surveillance exceeded the payer's utilization threshold.

How to fix

Carry the preterm-birth-risk diagnosis on every claim and appeal with the surveillance protocol, which specialty guidance supports at one- to two-week intervals for at-risk patients.

Source: ACOG/SMFM

CO-50 No documented indication for the transvaginal approach

Why it happens

The record did not show why a transvaginal exam was needed in addition to or instead of transabdominal imaging.

How to fix

Document the driver: inadequate transabdominal views, cervical assessment, or placental localization, and link the matching ICD-10 code.

Source: CMS

CO-16 Missing or invalid TC-26 modifier

Why it happens

Component billing was expected but modifiers were absent or duplicated across entities.

How to fix

Bill 76817-26 for the read and 76817-TC for the technical component, one entity each, and resubmit.

Source: CMS

FAQ

What is the CPT code description for 76817?

In plain language, 76817 covers an obstetric ultrasound performed through a transvaginal probe, used when the vaginal approach gives the needed view: early pregnancy confirmation, cervical length measurement, or precise placental localization.

Can I bill 76817 and a transabdominal scan on the same day?

Yes. A transvaginal exam and a transabdominal study, such as 76801 or 76815, are separately reportable when both are performed and separately documented. Some payers want modifier 59 on 76817 to flag the distinct approach.

What code do I use for a transvaginal scan on a non-pregnant patient?

76830, the gynecologic transvaginal code. 76817 requires a pregnancy. Billing both for one exam is an automatic edit.

How are serial cervical length checks billed?

Each surveillance visit is its own 76817 claim with the at-risk indication, such as prior preterm birth or short cervix, attached. Expect utilization review on long series and keep the protocol documented.

Is there an add-on for twins on 76817?

No. 76817 has no additional-fetus add-on; one unit covers the exam regardless of fetal number.

Is 76817 part of the global OB package?

No. Obstetric ultrasounds are billed separately from 59400, including transvaginal exams done during routine prenatal visits.

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.