Summary & Overview
CPT 76811: Transabdominal Obstetric Ultrasound, Fetal Anatomy Survey
CPT code 76811 denotes a transabdominal obstetric ultrasound that evaluates the fetus and mother with an expanded survey of fetal anatomy — including fetal heart rate, amniotic fluid assessment, placental location, and ventricular size. This code is widely used in prenatal diagnostic imaging and is important for documenting anatomical surveys that inform prenatal care, risk stratification, and follow-up planning. Nationally, use of this service impacts prenatal imaging utilization, prior-authorization workflows, and maternal-fetal care coordination.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the service is described clinically, typical sites of service, common billing modifiers associated with imaging claims, and the typical clinical findings captured during the study. The publication also summarizes benchmarking and reimbursement context, payer policy themes such as coverage criteria and documentation expectations, and coding considerations relevant for providers and billing staff. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 76811 describes an obstetric ultrasound performed via a transabdominal approach that evaluates both the fetus and the mother and includes an expanded assessment of fetal anatomy. The examination typically documents fetal heart rate, amniotic fluid volume, placental location, and measurements such as ventricular size.
Service type: Diagnostic obstetric ultrasound with fetal anatomy survey
Typical site of service: Outpatient imaging suite, hospital outpatient department, or ambulatory care clinic
Clinical & Coding Specifications
Clinical Context
A 28-year-old gravida 2, para 1 patient at 20 weeks' gestation presents to the outpatient obstetric ultrasound suite for a routine second-trimester fetal anatomic survey. The obstetrician ordered a transabdominal ultrasound to evaluate fetal anatomy, confirm fetal cardiac activity and heart rate, assess amniotic fluid volume, determine placental location, and measure fetal ventricular size and biometric parameters. The patient is positioned supine; a sonographer acquires standard transabdominal images of the fetus and maternal pelvis. The interpreting provider documents fetal number, presentation, cardiac motion and rate, placental position, amniotic fluid assessment (AFI or single deepest pocket), and detailed anatomic views per practice protocol. Images and measurements are saved in the PACS and a finalized report is sent to the ordering obstetrician. Typical sites of service are the hospital outpatient imaging department or an ambulatory obstetric clinic with ultrasound capability. This service is diagnostic and performed by credentialed sonographers and interpreted by an obstetrician, maternal-fetal medicine specialist, or radiologist.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpreting physician's professional service separate from facility technical component. |