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CPT code 76818: Fetal biophysical profile, with nonstress test2026 Medicare rate & RVUs in Washington, DC area

Reports fetal surveillance combining ultrasound assessment of biophysical activity and amniotic fluid with a nonstress test for the evaluated fetus.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Washington, DC area, Medicare pays $139.24 for 76818 in the office.

$139.24Office (non-facility)
Not available in this settingHospital or facility
+14.2%vs the national office rate ($121.91)

Check a contract rate as a % of Medicare · 76818 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 76818 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 76818 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 76818 covers

This service combines real-time ultrasound assessment of fetal breathing, movement, tone, and amniotic fluid with a nonstress test (NST). An obstetric sonographer or other qualified imaging staff may acquire the ultrasound images, while the interpreting physician or qualified practitioner evaluates and documents the findings. The NST records fetal heart-rate response, typically in an obstetric imaging or fetal surveillance setting when a biophysical profile is ordered with heart-rate testing.

Report 76818 when the documented assessment includes both the ultrasound biophysical profile and NST; use 76819 when the profile is performed without NST. The record should support the fetal assessment, ultrasound findings, NST results, and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. Reporting without either modifier represents the global service.

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 Washington, DC area compares for 76818

Across 109 of 109 payment localities, the office rate for 76818 runs from $108.72 in Arkansas to $162.37 in San Benito County, CA. Washington, DC area pays $139.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

76818 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$139.24
  2. Los Angeles, CA · California$138.17−$1.07
  3. Miami, FL · Florida$128.99−$10.25
  4. Chicago, IL · Illinois$125.61−$13.63
  5. Manhattan, NY · New York$139.32+$0.08
  6. Alaska · Alaska$143.46+$4.22
  7. Alabama · Alabama$110.21−$29.03

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

76818 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$108.72—
ArizonaArizona$118.93—
Bakersfield, CACalifornia$129.86—
Chico, CACalifornia$129.62—
El Centro, CACalifornia$129.63—
Fresno, CACalifornia$129.62—
Hanford, CACalifornia$129.62—
Madera, CACalifornia$129.62—

76818 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$108.72

$146.00

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

View every state and territory as a table
76818 office rate range by state
State / territoryOffice rate rangeLocalities
AK$143.461
AL$110.211
AR$108.721
AZ$118.931
CA$129.62–$162.3729
CO$127.281
CT$129.671
DC$139.241
DE$120.821
FL$119.33–$128.993
GA$113.13–$123.852
GU$132.641
HI$132.641
IA$113.241
ID$113.841
IL$115.79–$126.274
IN$114.471
KS$112.551
KY$112.221
LA$111.98–$117.192
MA$126.52–$139.642
MD$123.09–$139.243
ME$114.19–$120.282
MI$114.78–$120.522
MN$122.751
MO$110.05–$117.813
MS$109.421
MT$121.911
NC$115.341
ND$120.521
NE$113.881
NH$125.131
NJ$131.37–$137.902
NM$115.291
NV$121.611
NY$116.94–$142.265
OH$114.491
OK$112.241
OR$120.88–$131.352
PA$114.77–$126.482
PR$122.821
RI$125.131
SC$115.061
SD$120.361
TN$113.051
TX$114.05–$126.678
UT$116.541
VA$119.77–$139.242
VI$122.821
VT$119.901
WA$126.33–$142.602
WI$116.701
WV$111.721
WY$121.311

See 76818 in every payment locality

How the 76818 rate is calculated

Each of 76818’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 · 76818

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.02

1.02 RVUs× 1.000 GPCI

Practice expense2.56

2.56 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.6500

Conversion factor

$33.4009

Medicare rate

$121.91

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,796

Code
76818
Physician work
1.02
Practice expense
2.56
Malpractice
0.07

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 76818 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.02× 1.0541.0751
Practice expense2.56× 1.1783.0157
Malpractice0.07× 1.1130.0779
Total RVUs4.1687
Conversion factor× 33.4009

Office rate, Washington, DC area$139.24

Office: (1.02 × 1.054 + 2.56 × 1.178 + 0.07 × 1.113) × $33.4009 = $139.24

Open 76818 in the RVU calculator

Payment rules and modifiers for 76818

The CMS indicators that decide how 76818 is paid alongside other services.

CMS payment indicators · 76818

Fetal biophysical profile, with nonstress test

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

76818 without 26 · national office

$121.91

Fetal biophysical profile, with nonstress test

76818-26 · Professional component

$50.10

Pays only the interpretation and report.

When to use modifier 26

Codes related to 76818

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 76818
CodeHow it relatesOffice range, Washington, DC area
Used instead
76819Biophysical profile, without nonstress testReports a fetal biophysical profile performed without the NST component.$100.24
59025Fetal testing, nonstress testReports an NST alone when a full ultrasound biophysical profile is not performed.$56.96
Often billed with
76820Umbilical artery Doppler, fetal Doppler velocimetryUmbilical artery Doppler may be reported for a distinct fetal Doppler assessment.$51.02
76821Fetal Doppler, middle cerebral arteryMiddle cerebral artery Doppler may be reported for a distinct fetal Doppler assessment.$103.33

How 76818 has changed in Washington, DC area

76818 · Office / nonfacility

$139.24

Effective 2026-10-01

The base rate is $6.60 higher than on 2025-10-01, moving from $132.64 to $139.24 (5.0%).

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

    $132.64changed to$139.24

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.05 changed to 1.02
    • Practice expense RVU 2.46 changed to 2.56
    • Malpractice RVU 0.05 changed to 0.07
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.50changed to$132.64

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $134.27changed to$136.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $138.40changed to$134.27

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.39 changed to 2.46
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $139.79changed to$138.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.31 changed to 2.39
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $140.95changed to$139.79

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $140.32changed to$140.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.23 changed to 2.31
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $143.56changed to$140.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.28 changed to 2.23
    • Malpractice RVU 0.11 changed to 0.05
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $146.87changed to$143.56

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.36 changed to 2.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $147.00changed to$146.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.37 changed to 2.36
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $143.78changed to$147.00

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.30 changed to 2.37
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $143.87changed to$143.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.29 changed to 2.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $143.15changed to$143.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $142.84changed to$143.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.36 changed to 2.29
    • Malpractice RVU 0.04 changed to 0.11
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $145.39changed to$142.84

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.61 changed to 2.36
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $145.39

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$139.24Not available in this settingRVU26D
2026-07-01$139.24Not available in this settingRVU26C
2026-04-01$139.24Not available in this settingRVU26B
2026-01-01$139.24Not available in this settingRVU26A
2025-10-01$132.64Not available in this settingRVU25D
2025-07-01$132.64Not available in this settingRVU25C
2025-04-01$132.64Not available in this settingRVU25B
2025-01-01$132.64Not available in this settingRVU25A
2024-10-01$136.50Not available in this settingRVU24D
2024-07-01$136.50Not available in this settingRVU24C
2024-04-01$136.50Not available in this settingRVU24B
2024-03-09$136.50Not available in this settingRVU24AR
2024-01-01$134.27Not available in this settingRVU24A
2023-10-01$138.40Not available in this settingRVU23D
2023-07-01$138.40Not available in this settingRVU23C
2023-04-01$138.40Not available in this settingRVU23B
2023-01-01$138.40Not available in this settingRVU23A
2022-10-01$139.79Not available in this settingRVU22D
2022-07-01$139.79Not available in this settingRVU22C
2022-04-01$139.79Not available in this settingRVU22B
2022-01-01$139.79Not available in this settingRVU22A
2021-10-01$140.95Not available in this settingRVU21D
2021-07-01$140.95Not available in this settingRVU21C
2021-04-01$140.95Not available in this settingRVU21B
2021-01-01$140.95Not available in this settingRVU21A
2020-10-01$140.32Not available in this settingRVU20D
2020-07-01$140.32Not available in this settingRVU20C
2020-04-01$140.32Not available in this settingRVU20B
2020-01-01$140.32Not available in this settingRVU20A
2019-10-01$143.56Not available in this settingRVU19D
2019-07-01$143.56Not available in this settingRVU19C
2019-04-01$143.56Not available in this settingRVU19B
2019-01-01$143.56Not available in this settingRVU19A
2018-10-01$146.87Not available in this settingRVU18D
2018-07-01$146.87Not available in this settingRVU18C
2018-04-01$146.87Not available in this settingRVU18B
2018-01-01$146.87Not available in this settingRVU18AR1
2017-10-01$147.00Not available in this settingRVU17D
2017-07-01$147.00Not available in this settingRVU17C
2017-04-01$147.00Not available in this settingRVU17B
2017-01-01$147.00Not available in this settingRVU17A
2016-10-01$143.78Not available in this settingRVU16D
2016-07-01$143.78Not available in this settingRVU16C
2016-04-01$143.78Not available in this settingRVU16B
2016-01-01$143.78Not available in this settingRVU16A
2015-10-01$143.87Not available in this settingRVU15D
2015-07-01$143.87Not available in this settingRVU15C
2015-04-01$143.15Not available in this settingRVU15B
2015-01-01$143.15Not available in this settingRVU15A
2014-10-01$142.84Not available in this settingRVU14D
2014-07-01$142.84Not available in this settingRVU14C
2014-04-01$142.84Not available in this settingRVU14B
2014-01-01$142.84Not available in this settingRVU14A
2013-10-01$145.39Not available in this settingRVU13D
2013-07-01$145.39Not available in this settingRVU13C
2013-04-01$145.39Not available in this settingRVU13B
2013-01-01$145.39Not available in this settingRVU13AR

Price 76818 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

76818 billing questions

How is 76818 different from 76819?

76818 includes an NST along with the ultrasound biophysical profile. Use 76819 when the profile is performed without an NST.

Can the NST also be reported as 59025?

The NST is part of 76818 when it is performed as the NST component of that biophysical profile. Do not separately report 59025 for that same NST service.

What do modifiers 26 and TC represent?

Modifier 26 identifies the professional interpretation. Modifier TC identifies the technical service, including equipment and staff; without either modifier, the claim represents the global service.

What documentation supports 76818?

Document the ultrasound biophysical findings, amniotic fluid assessment, NST results, and the interpreting professional’s conclusion. The record should show that both ultrasound assessment and NST were performed.

Is 76818 reported per fetus or by time?

The service is a fetal assessment, not a timed service. Document which fetus or fetuses were assessed and the work performed for each.

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 76818PPRRVU2026_Oct_nonQPP.csv, line 8,796 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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