CPT code 76820: Umbilical artery Doppler, fetal Doppler velocimetry2026 Medicare rate & RVUs in Missouri
Reports Doppler assessment of fetal umbilical artery blood flow, commonly used in high-risk pregnancy monitoring when placental circulation is a concern.
Medicare pays $41.24–$43.76 for 76820 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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.
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What 76820 covers
This study uses ultrasound Doppler to assess blood-flow patterns in the fetal umbilical artery, providing information about circulation between the fetus and placenta. Maternal-fetal medicine specialists, obstetricians, or sonographers working under appropriate supervision may perform it in an office, imaging department, or hospital setting. It is commonly part of surveillance for a growth-restricted fetus or suspected placental insufficiency; it is distinct from a routine fetal anatomy or growth examination.
Report the service when the umbilical artery Doppler assessment is performed and documented, including the fetus assessed, the study findings, and the clinical indication. The record should support that this was a Doppler flow evaluation rather than only a general obstetric ultrasound. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing 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 76820 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$41.24 to $43.76
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $43.38 | Unavailable |
| Metropolitan St. Louis, MO | $43.76 | Unavailable |
| Rest of Missouri | $41.24 | Unavailable |
How the 76820 rate is calculated
Each of 76820’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 · 76820
RVUs × geographic indexes × conversion factor
Work0.49
0.49 RVUs× 1.000 GPCI
Practice expense0.83
0.83 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.3500
Conversion factor
$33.4009
Medicare rate
$45.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76820
The CMS indicators that decide how 76820 is paid alongside other services.
CMS payment indicators · 76820
Umbilical artery Doppler, fetal Doppler velocimetry
| 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
76820 without 26 · national office
$45.09
Umbilical artery Doppler, fetal Doppler velocimetry
76820-26 · Professional component
$24.05
Pays only the interpretation and report.
76820 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76821Fetal DopplerMiddle cerebral artery
- Use 76820 for umbilical artery Doppler findings and 76821 for middle cerebral artery Doppler findings. They identify different fetal vessels.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 reports a follow-up obstetric ultrasound focused on fetal reassessment, such as growth. It does not identify the specific umbilical artery Doppler service.
- 76818Fetal biophysical profileWith nonstress test
- 76818 reports a fetal biophysical profile performed with a nonstress test. Choose 76820 when the documented service is umbilical artery Doppler assessment.
76820 billing questions
How is this different from a middle cerebral artery Doppler?
This code is for Doppler assessment of the fetal umbilical artery. Use 76821 for the fetal middle cerebral artery; the vessel studied determines the code.
Can it be reported with a fetal growth ultrasound?
It may be reported with a separately performed growth assessment, such as 76816, when both the growth ultrasound and umbilical artery Doppler are documented as distinct services.
What do modifiers 26 and TC identify?
Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting this code?
Document the clinical reason for the Doppler, which fetus and vessel were assessed, and the flow findings or interpretation. A general obstetric ultrasound without a documented umbilical artery Doppler assessment does not support this service.
Is this the same as a fetal biophysical profile?
No. This code reports umbilical artery blood-flow assessment; 76818 and 76819 report fetal biophysical profile services, with and without a nonstress test, respectively.
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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