CPT code 76818: Fetal biophysical profile, with nonstress test2026 Medicare rate & RVUs in North Carolina
Reports fetal surveillance combining ultrasound assessment of biophysical activity and amniotic fluid with a nonstress test for the evaluated fetus.
In North Carolina, Medicare pays $115.34 for 76818 in the office.
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.
On this page 11 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.
How North Carolina 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. North Carolina pays $115.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$115.34
- Los Angeles, CA · California$138.17+$22.83
- Washington, DC area · District of Columbia$139.24+$23.90
- Miami, FL · Florida$128.99+$13.65
- Chicago, IL · Illinois$125.61+$10.27
- Manhattan, NY · New York$139.32+$23.98
- Alaska · Alaska$143.46+$28.12
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $129.62 | — |
| Merced, CACalifornia | $129.62 | — |
| Modesto, CACalifornia | $129.62 | — |
| Napa, CACalifornia | $150.10 | — |
| Oxnard, CACalifornia | $137.55 | — |
| Redding, CACalifornia | $129.62 | — |
| Rest of CaliforniaCalifornia | $129.62 | — |
| Riverside, CACalifornia | $130.39 | — |
| Sacramento, CACalifornia | $135.99 | — |
| Salinas, CACalifornia | $135.48 | — |
| San Diego, CACalifornia | $138.62 | — |
| Marin County, CACalifornia | $158.94 | — |
| San Francisco, CACalifornia | $158.86 | — |
| San Benito County, CACalifornia | $162.37 | — |
| Santa Clara County, CACalifornia | $162.04 | — |
| San Luis Obispo, CACalifornia | $133.29 | — |
| Santa Cruz, CACalifornia | $139.93 | — |
| Santa Maria, CACalifornia | $135.98 | — |
| Santa Rosa, CACalifornia | $141.35 | — |
| Stockton, CACalifornia | $129.62 | — |
| Vallejo, CACalifornia | $149.99 | — |
| Visalia, CACalifornia | $129.62 | — |
| Yuba City, CACalifornia | $129.62 | — |
| ColoradoColorado | $127.28 | — |
| ConnecticutConnecticut | $129.67 | — |
| DelawareDelaware | $120.82 | — |
| Fort Lauderdale, FLFlorida | $124.91 | — |
| Rest of FloridaFlorida | $119.33 | — |
| Atlanta, GAGeorgia | $123.85 | — |
| Rest of GeorgiaGeorgia | $113.13 | — |
| Hawaii, Guam, HIHawaii | $132.64 | — |
| IowaIowa | $113.24 | — |
| IdahoIdaho | $113.84 | — |
| East St. Louis, ILIllinois | $117.44 | — |
| Rest of IllinoisIllinois | $115.79 | — |
| Suburban Chicago, ILIllinois | $126.27 | — |
| IndianaIndiana | $114.47 | — |
| KansasKansas | $112.55 | — |
| KentuckyKentucky | $112.22 | — |
| New Orleans, LALouisiana | $117.19 | — |
| Rest of LouisianaLouisiana | $111.98 | — |
| Metropolitan Boston, MAMassachusetts | $139.64 | — |
| Rest of MassachusettsMassachusetts | $126.52 | — |
| Baltimore area, MDMaryland | $129.25 | — |
| Rest of MarylandMaryland | $123.09 | — |
| Rest of MaineMaine | $114.19 | — |
| Southern Maine, MEMaine | $120.28 | — |
| Detroit, MIMichigan | $120.52 | — |
| Rest of MichiganMichigan | $114.78 | — |
| MinnesotaMinnesota | $122.75 | — |
| Metropolitan Kansas City, MOMissouri | $116.64 | — |
| Metropolitan St. Louis, MOMissouri | $117.81 | — |
| Rest of MissouriMissouri | $110.05 | — |
| MississippiMississippi | $109.42 | — |
| MontanaMontana | $121.91 | — |
| North DakotaNorth Dakota | $120.52 | — |
| NebraskaNebraska | $113.88 | — |
| New HampshireNew Hampshire | $125.13 | — |
| Northern New JerseyNew Jersey | $137.90 | — |
| Rest of New JerseyNew Jersey | $131.37 | — |
| New MexicoNew Mexico | $115.29 | — |
| NevadaNevada | $121.61 | — |
| NYC suburbs and Long Island, NYNew York | $142.26 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $132.06 | — |
| Queens, NYNew York | $140.69 | — |
| Rest of New YorkNew York | $116.94 | — |
| OhioOhio | $114.49 | — |
| OklahomaOklahoma | $112.24 | — |
| Portland, OROregon | $131.35 | — |
| Rest of OregonOregon | $120.88 | — |
| Metropolitan Philadelphia, PAPennsylvania | $126.48 | — |
| Rest of PennsylvaniaPennsylvania | $114.77 | — |
| Puerto RicoPuerto Rico | $122.82 | — |
| Rhode IslandRhode Island | $125.13 | — |
| South CarolinaSouth Carolina | $115.06 | — |
| South DakotaSouth Dakota | $120.36 | — |
| TennesseeTennessee | $113.05 | — |
| Austin, TXTexas | $126.67 | — |
| Beaumont, TXTexas | $114.05 | — |
| Brazoria, TXTexas | $120.90 | — |
| Dallas, TXTexas | $121.55 | — |
| Fort Worth, TXTexas | $120.72 | — |
| Galveston, TXTexas | $121.19 | — |
| Houston, TXTexas | $122.47 | — |
| Rest of TexasTexas | $117.33 | — |
| UtahUtah | $116.54 | — |
| VirginiaVirginia | $119.77 | — |
| Virgin Islands, VIUnited States Virgin Islands | $122.82 | — |
| VermontVermont | $119.90 | — |
| Rest of WashingtonWashington | $126.33 | — |
| King County, WAWashington | $142.60 | — |
| WisconsinWisconsin | $116.70 | — |
| West VirginiaWest Virginia | $111.72 | — |
| WyomingWyoming | $121.31 | — |
76818 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.
$108.72
$146.00
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $143.46 | 1 |
| AL | $110.21 | 1 |
| AR | $108.72 | 1 |
| AZ | $118.93 | 1 |
| CA | $129.62–$162.37 | 29 |
| CO | $127.28 | 1 |
| CT | $129.67 | 1 |
| DC | $139.24 | 1 |
| DE | $120.82 | 1 |
| FL | $119.33–$128.99 | 3 |
| GA | $113.13–$123.85 | 2 |
| GU | $132.64 | 1 |
| HI | $132.64 | 1 |
| IA | $113.24 | 1 |
| ID | $113.84 | 1 |
| IL | $115.79–$126.27 | 4 |
| IN | $114.47 | 1 |
| KS | $112.55 | 1 |
| KY | $112.22 | 1 |
| LA | $111.98–$117.19 | 2 |
| MA | $126.52–$139.64 | 2 |
| MD | $123.09–$139.24 | 3 |
| ME | $114.19–$120.28 | 2 |
| MI | $114.78–$120.52 | 2 |
| MN | $122.75 | 1 |
| MO | $110.05–$117.81 | 3 |
| MS | $109.42 | 1 |
| MT | $121.91 | 1 |
| NC | $115.34 | 1 |
| ND | $120.52 | 1 |
| NE | $113.88 | 1 |
| NH | $125.13 | 1 |
| NJ | $131.37–$137.90 | 2 |
| NM | $115.29 | 1 |
| NV | $121.61 | 1 |
| NY | $116.94–$142.26 | 5 |
| OH | $114.49 | 1 |
| OK | $112.24 | 1 |
| OR | $120.88–$131.35 | 2 |
| PA | $114.77–$126.48 | 2 |
| PR | $122.82 | 1 |
| RI | $125.13 | 1 |
| SC | $115.06 | 1 |
| SD | $120.36 | 1 |
| TN | $113.05 | 1 |
| TX | $114.05–$126.67 | 8 |
| UT | $116.54 | 1 |
| VA | $119.77–$139.24 | 2 |
| VI | $122.82 | 1 |
| VT | $119.90 | 1 |
| WA | $126.33–$142.60 | 2 |
| WI | $116.70 | 1 |
| WV | $111.72 | 1 |
| WY | $121.31 | 1 |
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.
The exact North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.02 | × 1.000 | 1.0200 |
| Practice expense | 2.56 | × 0.933 | 2.3885 |
| Malpractice | 0.07 | × 0.639 | 0.0447 |
| Total RVUs | 3.4532 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$115.34
Office: (1.02 × 1 + 2.56 × 0.933 + 0.07 × 0.639) × $33.4009 = $115.34
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.
How 76818 has changed in North Carolina
76818 · Office / nonfacility
$115.34
Effective 2026-10-01
The base rate is $6.62 higher than on 2025-10-01, moving from $108.72 to $115.34 (6.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$108.72changed to$115.34
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$111.89changed to$108.72
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$110.06changed to$111.89
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$112.17changed to$110.06
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$112.22changed to$112.17
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.31 changed to 2.39
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$113.15changed to$112.22
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$114.11changed to$113.15
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$117.10changed to$114.11
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$119.65changed to$117.10
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.36 changed to 2.28
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$119.76changed to$119.65
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.37 changed to 2.36
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$117.20changed to$119.76
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.30 changed to 2.37
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$117.29changed to$117.20
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.29 changed to 2.30
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$116.71changed to$117.29
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$117.20changed to$116.71
- 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 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$118.99changed to$117.20
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.61 changed to 2.36
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $118.99
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $115.34 | Not available in this setting | RVU26D |
| 2026-07-01 | $115.34 | Not available in this setting | RVU26C |
| 2026-04-01 | $115.34 | Not available in this setting | RVU26B |
| 2026-01-01 | $115.34 | Not available in this setting | RVU26A |
| 2025-10-01 | $108.72 | Not available in this setting | RVU25D |
| 2025-07-01 | $108.72 | Not available in this setting | RVU25C |
| 2025-04-01 | $108.72 | Not available in this setting | RVU25B |
| 2025-01-01 | $108.72 | Not available in this setting | RVU25A |
| 2024-10-01 | $111.89 | Not available in this setting | RVU24D |
| 2024-07-01 | $111.89 | Not available in this setting | RVU24C |
| 2024-04-01 | $111.89 | Not available in this setting | RVU24B |
| 2024-03-09 | $111.89 | Not available in this setting | RVU24AR |
| 2024-01-01 | $110.06 | Not available in this setting | RVU24A |
| 2023-10-01 | $112.17 | Not available in this setting | RVU23D |
| 2023-07-01 | $112.17 | Not available in this setting | RVU23C |
| 2023-04-01 | $112.17 | Not available in this setting | RVU23B |
| 2023-01-01 | $112.17 | Not available in this setting | RVU23A |
| 2022-10-01 | $112.22 | Not available in this setting | RVU22D |
| 2022-07-01 | $112.22 | Not available in this setting | RVU22C |
| 2022-04-01 | $112.22 | Not available in this setting | RVU22B |
| 2022-01-01 | $112.22 | Not available in this setting | RVU22A |
| 2021-10-01 | $113.15 | Not available in this setting | RVU21D |
| 2021-07-01 | $113.15 | Not available in this setting | RVU21C |
| 2021-04-01 | $113.15 | Not available in this setting | RVU21B |
| 2021-01-01 | $113.15 | Not available in this setting | RVU21A |
| 2020-10-01 | $114.11 | Not available in this setting | RVU20D |
| 2020-07-01 | $114.11 | Not available in this setting | RVU20C |
| 2020-04-01 | $114.11 | Not available in this setting | RVU20B |
| 2020-01-01 | $114.11 | Not available in this setting | RVU20A |
| 2019-10-01 | $117.10 | Not available in this setting | RVU19D |
| 2019-07-01 | $117.10 | Not available in this setting | RVU19C |
| 2019-04-01 | $117.10 | Not available in this setting | RVU19B |
| 2019-01-01 | $117.10 | Not available in this setting | RVU19A |
| 2018-10-01 | $119.65 | Not available in this setting | RVU18D |
| 2018-07-01 | $119.65 | Not available in this setting | RVU18C |
| 2018-04-01 | $119.65 | Not available in this setting | RVU18B |
| 2018-01-01 | $119.65 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $119.76 | Not available in this setting | RVU17D |
| 2017-07-01 | $119.76 | Not available in this setting | RVU17C |
| 2017-04-01 | $119.76 | Not available in this setting | RVU17B |
| 2017-01-01 | $119.76 | Not available in this setting | RVU17A |
| 2016-10-01 | $117.20 | Not available in this setting | RVU16D |
| 2016-07-01 | $117.20 | Not available in this setting | RVU16C |
| 2016-04-01 | $117.20 | Not available in this setting | RVU16B |
| 2016-01-01 | $117.20 | Not available in this setting | RVU16A |
| 2015-10-01 | $117.29 | Not available in this setting | RVU15D |
| 2015-07-01 | $117.29 | Not available in this setting | RVU15C |
| 2015-04-01 | $116.71 | Not available in this setting | RVU15B |
| 2015-01-01 | $116.71 | Not available in this setting | RVU15A |
| 2014-10-01 | $117.20 | Not available in this setting | RVU14D |
| 2014-07-01 | $117.20 | Not available in this setting | RVU14C |
| 2014-04-01 | $117.20 | Not available in this setting | RVU14B |
| 2014-01-01 | $117.20 | Not available in this setting | RVU14A |
| 2013-10-01 | $118.99 | Not available in this setting | RVU13D |
| 2013-07-01 | $118.99 | Not available in this setting | RVU13C |
| 2013-04-01 | $118.99 | Not available in this setting | RVU13B |
| 2013-01-01 | $118.99 | Not available in this setting | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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