CPT code 76818: Fetal biophysical profile, with nonstress test2026 Medicare rate & RVUs in Maryland
Reports fetal surveillance combining ultrasound assessment of biophysical activity and amniotic fluid with a nonstress test for the evaluated fetus.
Medicare pays $123.09–$139.24 for 76818 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
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.
Where 76818 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$123.09 to $139.24
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $129.25 | Unavailable |
| Rest of Maryland | $123.09 | Unavailable |
| Washington, DC area | $139.24 | Unavailable |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
76818 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76819Biophysical profileWithout nonstress test
- Choose 76819 for an ultrasound biophysical profile without NST. Choose 76818 when NST is also performed as part of the profile.
- 59025Fetal testingNonstress test
- 59025 describes an NST without the ultrasound biophysical profile. When the NST is incorporated into the profile, 76818 describes the combined service.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 reports a follow-up obstetric ultrasound assessment; it is not a biophysical profile with NST.
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
Fee sheets · Coming soon
Put 76818 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist