CPT 76802
Global ZZZ ActiveOb us < 14 wks addl fetus
CPT 76802 Billing & Documentation Guide
CPT code 76802 (Ob us < 14 wks addl fetus) is classified under Radiology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.81, a non-facility practice expense RVU of 0.96, and a malpractice RVU of 0.04, a total non-facility RVU of 1.81 and facility RVU of 1.81. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $62.22, though rates vary from $55.29 to $76.98 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76802, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 76802 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 76802 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 76802
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.81 | 0.81 |
| Practice Expense RVU | 0.96 | 0.96 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 1.81 | 1.81 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76802
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $66.69 | $66.69 | $63.37 - $76.98 | 29 |
| Florida | $61.83 | $61.83 | $59.72 - $63.81 | 3 |
| Georgia | $59.29 | $59.29 | $57.25 - $61.32 | 2 |
| Illinois | $60.69 | $60.69 | $58.42 - $62.54 | 4 |
| Michigan | $59.05 | $59.05 | $57.84 - $60.25 | 2 |
| North Carolina | $57.82 | $57.82 | $57.82 - $57.82 | 1 |
| New York | $65.92 | $65.92 | $58.46 - $69.39 | 5 |
| Ohio | $57.68 | $57.68 | $57.68 - $57.68 | 1 |
| Pennsylvania | $60.14 | $60.14 | $57.75 - $62.52 | 2 |
| Texas | $60.01 | $60.01 | $57.47 - $62.22 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 76802
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76802 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0689T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0690T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 76942 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76970 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76986 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76998 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99446 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 76802
What does CPT code 76802 mean? +
CPT code 76802 represents: Ob us < 14 wks addl fetus. It's in the Radiology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 76802? +
The 2026 Medicare national average non-facility payment for CPT 76802 is $62.22. Rates range from $55.29 to $76.98 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76802? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 76802? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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