Summary & Overview
CPT 76830: Transvaginal Ultrasound Pelvic Examination
CPT code 76830 denotes a diagnostic transvaginal ultrasound of the female pelvis to evaluate the uterus, fallopian tubes, ovaries, cervix, and vagina. This imaging code is widely used in gynecology and obstetrics for evaluation of pelvic pain, abnormal bleeding, infertility workups, and characterization of adnexal or uterine pathology. Nationally, transvaginal ultrasound is a common, noninvasive diagnostic tool that influences clinical decision-making and downstream resource use.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how CPT code 76830 is processed by major payers and summarizes common billing considerations.
Readers will find a concise overview of clinical context and typical sites of service, a summary of payer coverage patterns and common modifiers encountered in billing, and related administrative details relevant to revenue-cycle staff and clinical administrators. The report highlights benchmarks and policy updates where available and provides practical context for coding workflows and documentation expectations. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 76830 describes a transvaginal ultrasound examination performed to assess the female reproductive organs, including the uterus, fallopian tubes, ovaries, cervix, and vagina. The procedure is an ultrasound-based pelvic imaging service using a transvaginal approach to obtain diagnostic images and measurements of gynecologic anatomy.
Service Type: Diagnostic imaging — transvaginal pelvic ultrasound
Typical Site of Service: Outpatient imaging centers, physician offices (gynecology or obstetrics), hospital outpatient departments
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Clinical & Coding Specifications
Clinical Context
A 32-year-old female presents to an outpatient gynecology clinic with pelvic pain and irregular vaginal bleeding. The clinician obtains a focused history, performs a pelvic exam, and orders a diagnostic transvaginal ultrasound to evaluate the uterus, endometrium, ovaries, and adnexa. The ultrasound is performed by a sonographer or the provider using a transvaginal probe; images and cine loops are obtained and interpreted contemporaneously. Indications include suspected ovarian cyst, evaluation of abnormal uterine bleeding, assessment of early intrauterine pregnancy or ectopic pregnancy, and pelvic inflammatory disease. Typical workflow: patient preparation and informed consent, placement of a transvaginal probe with sterile cover and gel, systematic imaging of uterus and adnexa, documentation of measurements (endometrial thickness, follicles/cysts, ovarian size), capture of representative images, provider review and interpretation, and generation of a written report. Typical site of service is an outpatient radiology or gynecology clinic, ambulatory surgery center, or emergency department when clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure | Use when a distinct E/M visit is performed and documented in addition to the transvaginal ultrasound on the same day |