CPT code 76813: Nuchal translucency, single or first gestation2026 Medicare rate & RVUs in West Virginia

Reports a first-trimester ultrasound measurement of fetal nuchal translucency for one fetus or the first fetus in a multiple gestation.

CMS RVU26DEffective Oct 1, 2026One payment locality788 Medicare services in 2024

In West Virginia, Medicare pays $106.77 for 76813 in the office.

$106.77Office (non-facility)
Not available in this settingHospital or facility
−7.6%vs the national office rate ($115.57)

Check a contract rate as a % of Medicare · 76813 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 76813 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in West Virginia
  2. What 76813 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 76813 covers

This obstetric ultrasound measures the fluid-filled space at the back of the fetal neck during first-trimester screening for chromosomal abnormalities. An ultrasound technologist or physician acquires the images, and an interpreting physician—often an obstetrician, radiologist, or maternal-fetal medicine specialist—documents the measurement. The scan may use a transabdominal or transvaginal approach, depending on the clinical circumstances and image quality.

Report 76813 for one fetus or the first fetus in a multiple gestation; report 76814 for each additional gestation when its measurement is performed. Documentation should support the number of fetuses assessed, the nuchal translucency measurement, image acquisition, and the physician’s interpretation. CMS recognizes professional and technical components: bill modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier for the global service. The professional and technical components have separate payment rates.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How West Virginia compares for 76813

Across 109 of 109 payment localities, the office rate for 76813 runs from $103.88 in Arkansas to $151.78 in San Benito County, CA. West Virginia pays $106.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

76813 in West Virginia vs other payment areas
  1. West Virginia · this page$106.77
  2. Los Angeles, CA · California$130.05+$23.28
  3. Washington, DC area · District of Columbia$131.22+$24.45
  4. Miami, FL · Florida$122.21+$15.44
  5. Chicago, IL · Illinois$119.24+$12.47
  6. Manhattan, NY · New York$131.52+$24.75
  7. Alaska · Alaska$138.59+$31.82

Other areas in West Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

76813 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$105.20—
ArkansasArkansas$103.88—
ArizonaArizona$112.91—
Bakersfield, CACalifornia$122.57—
Chico, CACalifornia$122.32—
El Centro, CACalifornia$122.33—
Fresno, CACalifornia$122.32—
Hanford, CACalifornia$122.32—

76813 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$103.88

$138.59

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
76813 office rate range by state
State / territoryOffice rate rangeLocalities
AK$138.591
AL$105.201
AR$103.881
AZ$112.911
CA$122.32–$151.7829
CO$120.301
CT$122.591
DC$131.221
DE$114.631
FL$113.45–$122.213
GA$107.94–$117.352
GU$124.831
HI$124.831
IA$107.801
ID$108.351
IL$110.37–$119.664
IN$108.901
KS$107.221
KY$107.061
LA$106.86–$111.472
MA$119.67–$131.402
MD$116.66–$131.223
ME$108.70–$114.032
MI$109.36–$114.552
MN$116.091
MO$105.18–$111.983
MS$104.561
MT$115.561
NC$109.711
ND$114.181
NE$108.351
NH$118.341
NJ$124.21–$130.122
NM$109.831
NV$115.251
NY$111.13–$134.175
OH$109.081
OK$107.041
OR$114.57–$123.892
PA$109.30–$119.782
PR$116.361
RI$118.511
SC$109.531
SD$114.011
TN$107.681
TX$108.67–$119.728
UT$110.841
VA$113.61–$131.222
VI$116.361
VT$113.661
WA$119.47–$134.042
WI$110.811
WV$106.771
WY$114.961

See 76813 in every payment locality

How the 76813 rate is calculated

Each of 76813’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 76813

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.15

1.15 RVUs× 1.000 GPCI

Practice expense2.24

2.24 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.4600

Conversion factor

$33.4009

Medicare rate

$115.57

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact West Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,781

Code
76813
Physician work
1.15
Practice expense
2.24
Malpractice
0.07

GPCI2026.csv

110

Locality
West Virginia
Physician work
1.000
Practice expense
0.869
Malpractice
1.431
Office calculation for 76813 in West Virginia
ComponentRVULocality factorAdjusted
Physician work1.15× 1.0001.1500
Practice expense2.24× 0.8691.9466
Malpractice0.07× 1.4310.1002
Total RVUs3.1967
Conversion factor× 33.4009

Office rate, West Virginia$106.77

Office: (1.15 × 1 + 2.24 × 0.869 + 0.07 × 1.431) × $33.4009 = $106.77

Open 76813 in the RVU calculator

Payment rules and modifiers for 76813

The CMS indicators that decide how 76813 is paid alongside other services.

CMS payment indicators · 76813

Nuchal translucency, single or first gestation

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

76813 without 26 · national office

$115.57

Nuchal translucency, single or first gestation

76813-26 · Professional component

$56.45

Pays only the interpretation and report.

When to use modifier 26

How 76813 has changed in West Virginia

76813 · Office / nonfacility

$106.77

Effective 2026-10-01

The base rate is $6.09 higher than on 2025-10-01, moving from $100.68 to $106.77 (6.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $100.68changed to$106.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.18 changed to 1.15
    • Practice expense RVU 2.18 changed to 2.24
    • Malpractice RVU 0.04 changed to 0.07
    • Practice expense GPCI 0.862 changed to 0.869
    • Malpractice GPCI 1.333 changed to 1.431

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $105.62changed to$100.68

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.25 changed to 2.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $103.89changed to$105.62

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $108.87changed to$103.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.29 changed to 2.25
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.860 changed to 0.862
    • Malpractice GPCI 1.266 changed to 1.333
  5. January 1, 2023

    RVU23A

    $111.20changed to$108.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.30 changed to 2.29
    • Practice expense GPCI 0.858 changed to 0.860
    • Malpractice GPCI 1.198 changed to 1.266

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.32changed to$111.20

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.34 changed to 2.30

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $112.71changed to$113.32

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.18 changed to 2.34
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.857 changed to 0.858
    • Malpractice GPCI 1.247 changed to 1.198

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $114.38changed to$112.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.16 changed to 2.18
    • Malpractice RVU 0.11 changed to 0.06
    • Malpractice GPCI 1.296 changed to 1.247

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $115.18changed to$114.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.19 changed to 2.16

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $114.31changed to$115.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.20 changed to 2.19
    • Practice expense GPCI 0.847 changed to 0.857
    • Malpractice GPCI 1.289 changed to 1.296

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $111.65changed to$114.31

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.15 changed to 2.20
    • Practice expense GPCI 0.836 changed to 0.847
    • Malpractice GPCI 1.282 changed to 1.289

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $112.52changed to$111.65

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.12 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $111.96changed to$112.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $109.79changed to$111.96

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.19 changed to 2.15
    • Malpractice RVU 0.05 changed to 0.12
    • Practice expense GPCI 0.832 changed to 0.836
    • Malpractice GPCI 1.256 changed to 1.282

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $110.41changed to$109.79

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.42 changed to 2.19
    • Practice expense GPCI 0.828 changed to 0.832
    • Malpractice GPCI 1.229 changed to 1.256

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $110.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$106.77Not available in this settingRVU26D
2026-07-01$106.77Not available in this settingRVU26C
2026-04-01$106.77Not available in this settingRVU26B
2026-01-01$106.77Not available in this settingRVU26A
2025-10-01$100.68Not available in this settingRVU25D
2025-07-01$100.68Not available in this settingRVU25C
2025-04-01$100.68Not available in this settingRVU25B
2025-01-01$100.68Not available in this settingRVU25A
2024-10-01$105.62Not available in this settingRVU24D
2024-07-01$105.62Not available in this settingRVU24C
2024-04-01$105.62Not available in this settingRVU24B
2024-03-09$105.62Not available in this settingRVU24AR
2024-01-01$103.89Not available in this settingRVU24A
2023-10-01$108.87Not available in this settingRVU23D
2023-07-01$108.87Not available in this settingRVU23C
2023-04-01$108.87Not available in this settingRVU23B
2023-01-01$108.87Not available in this settingRVU23A
2022-10-01$111.20Not available in this settingRVU22D
2022-07-01$111.20Not available in this settingRVU22C
2022-04-01$111.20Not available in this settingRVU22B
2022-01-01$111.20Not available in this settingRVU22A
2021-10-01$113.32Not available in this settingRVU21D
2021-07-01$113.32Not available in this settingRVU21C
2021-04-01$113.32Not available in this settingRVU21B
2021-01-01$113.32Not available in this settingRVU21A
2020-10-01$112.71Not available in this settingRVU20D
2020-07-01$112.71Not available in this settingRVU20C
2020-04-01$112.71Not available in this settingRVU20B
2020-01-01$112.71Not available in this settingRVU20A
2019-10-01$114.38Not available in this settingRVU19D
2019-07-01$114.38Not available in this settingRVU19C
2019-04-01$114.38Not available in this settingRVU19B
2019-01-01$114.38Not available in this settingRVU19A
2018-10-01$115.18Not available in this settingRVU18D
2018-07-01$115.18Not available in this settingRVU18C
2018-04-01$115.18Not available in this settingRVU18B
2018-01-01$115.18Not available in this settingRVU18AR1
2017-10-01$114.31Not available in this settingRVU17D
2017-07-01$114.31Not available in this settingRVU17C
2017-04-01$114.31Not available in this settingRVU17B
2017-01-01$114.31Not available in this settingRVU17A
2016-10-01$111.65Not available in this settingRVU16D
2016-07-01$111.65Not available in this settingRVU16C
2016-04-01$111.65Not available in this settingRVU16B
2016-01-01$111.65Not available in this settingRVU16A
2015-10-01$112.52Not available in this settingRVU15D
2015-07-01$112.52Not available in this settingRVU15C
2015-04-01$111.96Not available in this settingRVU15B
2015-01-01$111.96Not available in this settingRVU15A
2014-10-01$109.79Not available in this settingRVU14D
2014-07-01$109.79Not available in this settingRVU14C
2014-04-01$109.79Not available in this settingRVU14B
2014-01-01$109.79Not available in this settingRVU14A
2013-10-01$110.41Not available in this settingRVU13D
2013-07-01$110.41Not available in this settingRVU13C
2013-04-01$110.41Not available in this settingRVU13B
2013-01-01$110.41Not available in this settingRVU13AR

Price 76813 for an earlier date of service

Where the West Virginia rate applies

West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Accoville
  • Addison (Webster Springs)
  • Adrian
  • Albright
  • Alderson
  • Alum Creek
  • Amherstdale
  • Anawalt

Browse all communities in West Virginia

76813 billing questions

How does 76813 differ from 76801?

76813 reports the first-trimester nuchal translucency measurement. 76801 is for a first-trimester obstetric ultrasound examination, rather than the specific NT measurement.

How is 76813 used for a multiple gestation?

Report 76813 for the first fetus assessed and 76814 for each additional fetus with a separately performed NT measurement.

Can the professional and technical services be billed separately?

Yes. Use modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff; billing without either modifier represents the global service.

What documentation supports 76813?

The record should identify the fetus assessed and include the NT measurement, supporting images, and the interpreting physician’s findings.

Does 76813 represent a complete first-trimester anatomy survey?

No. It represents the nuchal translucency measurement; use 76801 when a complete first-trimester obstetric ultrasound examination is performed and documented.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 76813PPRRVU2026_Oct_nonQPP.csv, line 8,781 (RVU26D)
Geographic factors for West VirginiaGPCI2026.csv, line 110 (RVU26D)

Open CMS sourceHow we calculate rates

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