CPT76856

Ultrasound Pelvis Cost in Delaware

Us exam pelvic complete

$212Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Delaware Medicare physician rate (2026)

-1.0% vs national

Single statewide locality.

Delaware (Hospital)
$104.18
Facility physician fee
Private plan est.
$135–$208
~130–200% of Medicare
Cash / self-pay est.
$83–$156
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$162
$105 physician + $57 facility
Physician fee alone
$105
Only 50% of the hospital total

Choosing a surgery centre over a hospital saves about $50 on the Medicare allowed amount for ultrasound pelvis. Ask whether your procedure can be done at an ambulatory surgery centre.

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Delaware

Run a ZIP lookup to see figures for Wilmington and New Castle County, Dover, or the Rehoboth and Lewes area in fast-growing Sussex County.

What ultrasound pelvis costs at hospitals near you

Everything above is a national average. The hospital you pick in Delaware moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

National vs Delaware

National office$105.21
National hospital (physician)$105.21
Delaware vs nationalwithin 2% of the national office rate of $105.21

Where Delaware ranks for this CPT

Rank (lowest physician fee first)#31 of 51
Lowest stateArkansas ($92.96)
Highest stateDistrict of Columbia ($121.06)

Ultrasound Pelvis and how Delaware is priced

Delaware runs on a single statewide payment locality, one of the simplest setups in the fee schedule, with adjustment factors a notch above the national average given its Mid-Atlantic wage levels. From Wilmington down to the Sussex County beaches, the published Medicare rates are identical. The state's small size means locality boundaries would add little, and CMS has never subdivided it. What changes across the state is mostly provider availability rather than the approved amounts themselves.

Northern Delaware functions as part of the greater Philadelphia medical market, and Wilmington-area residents frequently use Philadelphia's academic centers for complex care. Downstate, Kent and Sussex counties rely on regional hospitals, and the fast-growing retiree population along the coast has stretched specialist capacity. Many beach-area patients travel north or into Maryland for procedures that require a subspecialist.

This procedure: A complete pelvic ultrasound scans the bladder, uterus, and ovaries through the lower abdomen using a probe on the skin, requiring a full bladder to push bowel out of the way and create a clear acoustic window. It evaluates pelvic pain, fibroids, and masses, and in males or by protocol it examines the bladder and surrounding structures. The exam takes 15 to 30 minutes; the full-bladder requirement is most patients' only complaint.

What Is Ultrasound Pelvis?

A complete pelvic ultrasound scans the bladder, uterus, and ovaries through the lower abdomen using a probe on the skin, requiring a full bladder to push bowel out of the way and create a clear acoustic window. It evaluates pelvic pain, fibroids, and masses, and in males or by protocol it examines the bladder and surrounding structures. The exam takes 15 to 30 minutes; the full-bladder requirement is most patients' only complaint.

What Affects the Cost

  • It is commonly paired with a transvaginal study (76830) in one appointment, producing two billed exams.
  • Hospital imaging departments price this study well above independent centers and office-based machines.
  • An inadequately filled bladder can force rebooking, effectively costing a second visit.
  • A limited pelvic ultrasound is a cheaper code when only one structure needs a follow-up look.
  • Separate professional reading fees apply where radiologists interpret off-site.

Questions to Ask Before Booking

  • 1.Is a complete study needed, or is this a follow-up that qualifies for the cheaper limited code?
  • 2.Will a transvaginal exam likely be added during the visit, and what would both together cost?
  • 3.What are the bladder-filling instructions so I am not rebooked?
  • 4.What is the price difference between your office, an imaging center, and the hospital?
  • 5.What diagnosis is on the order to support coverage?

Ultrasound Pelvis in Delaware: questions

Delaware is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 76856 is $104.18 in an office and $104.18 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Delaware uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $21 for the office physician line or $21 for the hospital physician line in Delaware. Medigap may cover that 20%. This is not the hospital facility fee.

No. $104.18 is only the physician's share. Adding Medicare's facility payment brings the total to about $212 in a hospital outpatient department, or about $162 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Delaware ranks #31 of 51 states on the physician line (within 2% of the national office rate of $105.21).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.