CPT 76801 Radiology

How Much Does Ob us < 14 wks single fetus Cost?

Ob us < 14 wks single fetus (CPT 76801) costs $117 at Medicare rates. Hospital outpatient rate: $107.

Cost Comparison by Payer

How much Ob us < 14 wks single fetus costs across different settings and payers

Medicare
Facility rate
$117
Hospital Outpatient
OPPS rate
$107
Surgery Center
ASC rate
$57
Medicare (Facility)
$117
CMS PFS 2026 national rate
Hospital Outpatient
$107
OPPS rate
Surgery Center (ASC)
$57
Ambulatory surgery center

How to Reduce Your Cost for Ob us < 14 wks single fetus

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $57, compared to $107 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.97
Work RVU
2.47
Practice Expense RVU
0.06
Malpractice RVU
3.50
Total RVU

Payment = Total RVU (3.50) x CF ($33.40) = $117

Frequently Asked Questions

How much does Ob us < 14 wks single fetus cost?

The Medicare facility rate for Ob us < 14 wks single fetus is $117. In a hospital outpatient setting, the rate is $107. At an ambulatory surgery center, the rate is $57. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Ob us < 14 wks single fetus cost without insurance?

Without insurance, the cost of Ob us < 14 wks single fetus can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Ob us < 14 wks single fetus?

Most commercial health insurance plans and Medicare cover Ob us < 14 wks single fetus when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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