August 7, 2025
CPT code 76817 is essential for gynecologic and early obstetric imaging, but confusion with abdominal codes (e.g., liver/gallbladder exams) can lead to claim denials. Here’s how to use 76817 accurately and avoid costly mistakes.
CPT 76817 describes a transvaginal ultrasound, where a probe is inserted into the vagina to obtain detailed pelvic images. It’s commonly used for:
Avoid mix-ups with these related codes:
Yes, if both exams are medically necessary and documented (e.g., Trans abdominal + transvaginal for ectopic pregnancy evaluation). Use modifier -59 if required.
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CPT 76817 is critical for pelvic diagnostics, but confusion with abdominal codes like 76700 (liver/gallbladder) or 76801 (limited OB) risks denials. Always document the transvaginal approach, justify medical billing necessity, and follow payer guidelines. When in doubt, ask: “Was this exam internal (vaginal) or external (abdominal)?”
CPT 76817 is used to report a transvaginal ultrasound performed to assess the uterus, ovaries, adnexa, and pelvic structures, typically during pregnancy or for gynecologic evaluation.
While both are for transvaginal ultrasounds, CPT 76817 is used during pregnancy, and CPT 76830 is used for non-pregnant pelvic ultrasound evaluations.
Yes, CPT 76817 is generally covered by insurance when medically necessary, such as for evaluating early pregnancy, fetal viability, or gynecologic issues. Always verify payer-specific policies.
Sometimes, but not always. If multiple ultrasounds are performed on the same day (e.g., abdominal + transvaginal), modifier usage (e.g., 59 or XS) may be required to avoid bundling or denials.
Proper documentation should include medical necessity, findings (uterus, ovaries, adnexa, fetal heartbeat if applicable), date, time, and provider credentials.
Reimbursement varies by location and payer, but the national average is between $85–$130 for professional and technical components combined. Always check the current CMS fee schedule.
Common modifiers include:
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