76830
Transvaginal ultrasound
Ultrasound of the pelvis, transvaginal approach. CMS 2026 global wRVU 0.69, total RVU approximately 2.25, Medicare global allowable approximately $75. The first-line gynecologic and early-OB imaging study, also used for urologic and bladder evaluation.
When to use it
Use 76830 for transvaginal ultrasound of the female pelvis. Common indications: early pregnancy dating, fetal viability assessment (in the first trimester), suspected ectopic pregnancy, abnormal uterine bleeding, postmenopausal bleeding workup, suspected adnexal mass, IUD positioning, evaluation of pelvic pain.
Full guidance
Pair with 76856 (pelvic ultrasound non-OB complete) or 76801-76817 (OB-specific codes) if a separate transabdominal pelvic study is also performed in the same session.
Documentation checklist
- ✓Order with indication.
- ✓Interpretation report addresses uterus (size, contour, endometrial stripe thickness), bilateral ovaries (size, presence/absence of cysts or masses), cul-de-sac for free fluid, adnexa for masses or hydrosalpinx.
- ✓If early pregnancy, document gestational sac (location, mean diameter), yolk sac, fetal pole, cardiac activity, and intrauterine versus extrauterine location.
- ✓Images saved.
- ✓Setting modifier; signed report.
Common pitfalls
- !Billing 76830 plus 76856 (pelvic US complete non-OB) on the same date for the same patient when the transabdominal study was not separately performed. The transvaginal study is one approach to the same anatomy; bill both only when both methods were used.
- !Billing 76830 plus 76817 (transvaginal OB > first trimester) on the same date. 76817 is the dedicated OB transvaginal code for after the first trimester.
- !Using 76830 for male pelvic ultrasound — that's transrectal, code 76872.
- !Missing endometrial measurement in postmenopausal bleeding workup. Stripe thickness is the structural deliverable; absent measurement defeats the indication.
- !Confusing 76830 with limited transvaginal codes used in IUD localization (sometimes billed as 76857 limited or 76830 complete depending on documentation).
Payer notes
Medicare and commercial payers cover 76830 with appropriate indication. The procedure is patient-positioning intensive; document patient consent for the transvaginal approach. Some commercial payers cover OB-related transvaginal US under maternity benefits with different copay; verify benefits when the indication is pregnancy-related.