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

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 Delaware, Medicare pays $120.82 for 76818 in the office.

$120.82Office (non-facility)
Not available in this settingHospital or facility
−0.9%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 Delaware
  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 Delaware 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. Delaware pays $120.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

76818 in Delaware vs other payment areas
  1. Delaware · this page$120.82
  2. Los Angeles, CA · California$138.17+$17.35
  3. Washington, DC area · District of Columbia$139.24+$18.42
  4. Miami, FL · Florida$128.99+$8.17
  5. Chicago, IL · Illinois$125.61+$4.79
  6. Manhattan, NY · New York$139.32+$18.50
  7. Alaska · Alaska$143.46+$22.64

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

Every other payment area

76818 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$110.21—
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—

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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 76818 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.02× 1.0051.0251
Practice expense2.56× 0.9882.5293
Malpractice0.07× 0.8990.0629
Total RVUs3.6173
Conversion factor× 33.4009

Office rate, Delaware$120.82

Office: (1.02 × 1.005 + 2.56 × 0.988 + 0.07 × 0.899) × $33.4009 = $120.82

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, Delaware
Used instead
76819Biophysical profile, without nonstress testReports a fetal biophysical profile performed without the NST component.$87.04
59025Fetal testing, nonstress testReports an NST alone when a full ultrasound biophysical profile is not performed.$49.71
Often billed with
76820Umbilical artery Doppler, fetal Doppler velocimetryUmbilical artery Doppler may be reported for a distinct fetal Doppler assessment.$44.74
76821Fetal Doppler, middle cerebral arteryMiddle cerebral artery Doppler may be reported for a distinct fetal Doppler assessment.$89.37

How 76818 has changed in Delaware

76818 · Office / nonfacility

$120.82

Effective 2026-10-01

The base rate is $6.08 higher than on 2025-10-01, moving from $114.74 to $120.82 (5.3%).

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

    $114.74changed to$120.82

    • 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 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $118.08changed to$114.74

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $116.15changed to$118.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $119.30changed to$116.15

    • 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 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $120.14changed to$119.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.31 changed to 2.39
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.14changed to$120.14

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $122.14changed to$121.14

    • 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 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $126.27changed to$122.14

    • 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 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $129.07changed to$126.27

    • 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

    $129.59changed to$129.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.37 changed to 2.36
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $127.21changed to$129.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.30 changed to 2.37
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $127.30changed to$127.21

    • 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

    $126.67changed to$127.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $127.08changed to$126.67

    • 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
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $129.77changed to$127.08

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.61 changed to 2.36
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $129.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$120.82Not available in this settingRVU26D
2026-07-01$120.82Not available in this settingRVU26C
2026-04-01$120.82Not available in this settingRVU26B
2026-01-01$120.82Not available in this settingRVU26A
2025-10-01$114.74Not available in this settingRVU25D
2025-07-01$114.74Not available in this settingRVU25C
2025-04-01$114.74Not available in this settingRVU25B
2025-01-01$114.74Not available in this settingRVU25A
2024-10-01$118.08Not available in this settingRVU24D
2024-07-01$118.08Not available in this settingRVU24C
2024-04-01$118.08Not available in this settingRVU24B
2024-03-09$118.08Not available in this settingRVU24AR
2024-01-01$116.15Not available in this settingRVU24A
2023-10-01$119.30Not available in this settingRVU23D
2023-07-01$119.30Not available in this settingRVU23C
2023-04-01$119.30Not available in this settingRVU23B
2023-01-01$119.30Not available in this settingRVU23A
2022-10-01$120.14Not available in this settingRVU22D
2022-07-01$120.14Not available in this settingRVU22C
2022-04-01$120.14Not available in this settingRVU22B
2022-01-01$120.14Not available in this settingRVU22A
2021-10-01$121.14Not available in this settingRVU21D
2021-07-01$121.14Not available in this settingRVU21C
2021-04-01$121.14Not available in this settingRVU21B
2021-01-01$121.14Not available in this settingRVU21A
2020-10-01$122.14Not available in this settingRVU20D
2020-07-01$122.14Not available in this settingRVU20C
2020-04-01$122.14Not available in this settingRVU20B
2020-01-01$122.14Not available in this settingRVU20A
2019-10-01$126.27Not available in this settingRVU19D
2019-07-01$126.27Not available in this settingRVU19C
2019-04-01$126.27Not available in this settingRVU19B
2019-01-01$126.27Not available in this settingRVU19A
2018-10-01$129.07Not available in this settingRVU18D
2018-07-01$129.07Not available in this settingRVU18C
2018-04-01$129.07Not available in this settingRVU18B
2018-01-01$129.07Not available in this settingRVU18AR1
2017-10-01$129.59Not available in this settingRVU17D
2017-07-01$129.59Not available in this settingRVU17C
2017-04-01$129.59Not available in this settingRVU17B
2017-01-01$129.59Not available in this settingRVU17A
2016-10-01$127.21Not available in this settingRVU16D
2016-07-01$127.21Not available in this settingRVU16C
2016-04-01$127.21Not available in this settingRVU16B
2016-01-01$127.21Not available in this settingRVU16A
2015-10-01$127.30Not available in this settingRVU15D
2015-07-01$127.30Not available in this settingRVU15C
2015-04-01$126.67Not available in this settingRVU15B
2015-01-01$126.67Not available in this settingRVU15A
2014-10-01$127.08Not available in this settingRVU14D
2014-07-01$127.08Not available in this settingRVU14C
2014-04-01$127.08Not available in this settingRVU14B
2014-01-01$127.08Not available in this settingRVU14A
2013-10-01$129.77Not available in this settingRVU13D
2013-07-01$129.77Not available in this settingRVU13C
2013-04-01$129.77Not available in this settingRVU13B
2013-01-01$129.77Not available in this settingRVU13AR

Price 76818 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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