Ultrasound Pelvis Cost in Pennsylvania
Us exam pelvic complete
$212Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-1.3% vs nationalAverage of 2 localities. Office range $98.47–$109.27.
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.
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 Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What ultrasound pelvis costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
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 Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 76856 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $109.27 |
| rest of pennsylvania | $98.47 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Ultrasound Pelvis and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
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?
Other featured procedures in Pennsylvania
Ultrasound Pelvis in other states
Ultrasound Pelvis in Pennsylvania: questions
The 2026 Medicare physician office rate for CPT 76856 averages $103.87 across 2 Pennsylvania localities, from $98.47 in REST OF PENNSYLVANIA to $109.27 in METROPOLITAN PHILADELPHIA. The hospital physician rate averages $103.87. Enter a ZIP for the exact locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $10.80 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
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 Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
No. $103.87 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. Pennsylvania ranks #27 of 51 states on the physician line (within 2% of the national office rate of $105.21).