CPT code 76821: Fetal Doppler, middle cerebral artery2026 Medicare rate & RVUs in Washington, DC area
Reports fetal Doppler assessment of the middle cerebral artery, used chiefly to evaluate fetal anemia through blood-flow velocity measurements.
In Washington, DC area, Medicare pays $103.33 for 76821 in the office.
Check a contract rate as a % of Medicare · 76821 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 76821 covers
An obstetric sonographer or qualified imaging professional obtains Doppler waveforms from the fetus’s middle cerebral artery; the interpreting physician evaluates flow, commonly including peak systolic velocity. Maternal-fetal medicine specialists use the measurement to assess concern for fetal anemia, such as in a pregnancy affected by red-cell alloimmunization or another condition associated with fetal anemia. The examination is performed as a targeted fetal Doppler study in prenatal imaging settings.
This code identifies MCA assessment, not umbilical-artery flow or a general fetal growth survey. The record should support the clinical indication, vessel examined, Doppler findings, and physician interpretation. CMS recognizes professional and technical components: report modifier 26 for interpretation, TC for equipment and staff, or neither modifier for the global service. The professional and technical components are separately priced in the fee schedule. When MCA and umbilical artery Doppler studies are both performed, the documentation should identify each vessel assessed.
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 76821
Across 109 of 109 payment localities, the office rate for 76821 runs from $80.21 in Arkansas to $121.29 in San Benito County, CA. Washington, DC area pays $103.33. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$103.33
- Los Angeles, CA · California$102.77−$0.56
- Miami, FL · Florida$94.94−$8.39
- Chicago, IL · Illinois$92.40−$10.93
- Manhattan, NY · New York$103.13−$0.20
- Alaska · Alaska$105.24+$1.91
- Alabama · Alabama$81.34−$21.99
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $80.21 | — |
| ArizonaArizona | $87.94 | — |
| Bakersfield, CACalifornia | $96.44 | — |
| Chico, CACalifornia | $96.30 | — |
| El Centro, CACalifornia | $96.30 | — |
| Fresno, CACalifornia | $96.30 | — |
| Hanford, CACalifornia | $96.30 | — |
| Madera, CACalifornia | $96.30 | — |
| Merced, CACalifornia | $96.30 | — |
| Modesto, CACalifornia | $96.30 | — |
| Napa, CACalifornia | $111.99 | — |
| Oxnard, CACalifornia | $102.35 | — |
| Redding, CACalifornia | $96.30 | — |
| Rest of CaliforniaCalifornia | $96.30 | — |
| Riverside, CACalifornia | $96.74 | — |
| Sacramento, CACalifornia | $101.16 | — |
| Salinas, CACalifornia | $100.78 | — |
| San Diego, CACalifornia | $103.21 | — |
| Marin County, CACalifornia | $118.73 | — |
| San Francisco, CACalifornia | $118.69 | — |
| San Benito County, CACalifornia | $121.29 | — |
| Santa Clara County, CACalifornia | $121.11 | — |
| San Luis Obispo, CACalifornia | $99.14 | — |
| Santa Cruz, CACalifornia | $104.26 | — |
| Santa Maria, CACalifornia | $101.18 | — |
| Santa Rosa, CACalifornia | $105.32 | — |
| Stockton, CACalifornia | $96.30 | — |
| Vallejo, CACalifornia | $111.92 | — |
| Visalia, CACalifornia | $96.30 | — |
| Yuba City, CACalifornia | $96.30 | — |
| ColoradoColorado | $94.39 | — |
| ConnecticutConnecticut | $96.01 | — |
| DelawareDelaware | $89.37 | — |
| Fort Lauderdale, FLFlorida | $92.12 | — |
| Rest of FloridaFlorida | $87.94 | — |
| Atlanta, GAGeorgia | $91.58 | — |
| Rest of GeorgiaGeorgia | $83.30 | — |
| Hawaii, Guam, HIHawaii | $98.68 | — |
| IowaIowa | $83.76 | — |
| IdahoIdaho | $84.19 | — |
| East St. Louis, ILIllinois | $86.25 | — |
| Rest of IllinoisIllinois | $85.18 | — |
| Suburban Chicago, ILIllinois | $93.16 | — |
| IndianaIndiana | $84.67 | — |
| KansasKansas | $83.17 | — |
| KentuckyKentucky | $82.73 | — |
| New Orleans, LALouisiana | $86.46 | — |
| Rest of LouisianaLouisiana | $82.52 | — |
| Metropolitan Boston, MAMassachusetts | $103.80 | — |
| Rest of MassachusettsMassachusetts | $93.78 | — |
| Baltimore area, MDMaryland | $95.69 | — |
| Rest of MarylandMaryland | $91.09 | — |
| Rest of MaineMaine | $84.39 | — |
| Southern Maine, MEMaine | $89.09 | — |
| Detroit, MIMichigan | $88.78 | — |
| Rest of MichiganMichigan | $84.60 | — |
| MinnesotaMinnesota | $91.16 | — |
| Metropolitan Kansas City, MOMissouri | $86.12 | — |
| Metropolitan St. Louis, MOMissouri | $87.01 | — |
| Rest of MissouriMissouri | $81.02 | — |
| MississippiMississippi | $80.64 | — |
| MontanaMontana | $90.18 | — |
| North CarolinaNorth Carolina | $85.27 | — |
| North DakotaNorth Dakota | $89.39 | — |
| NebraskaNebraska | $84.26 | — |
| New HampshireNew Hampshire | $92.73 | — |
| Northern New JerseyNew Jersey | $102.29 | — |
| Rest of New JerseyNew Jersey | $97.30 | — |
| New MexicoNew Mexico | $84.96 | — |
| NevadaNevada | $90.03 | — |
| NYC suburbs and Long Island, NYNew York | $105.28 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $97.77 | — |
| Queens, NYNew York | $104.26 | — |
| Rest of New YorkNew York | $86.48 | — |
| OhioOhio | $84.44 | — |
| OklahomaOklahoma | $82.81 | — |
| Portland, OROregon | $97.54 | — |
| Rest of OregonOregon | $89.52 | — |
| Metropolitan Philadelphia, PAPennsylvania | $93.56 | — |
| Rest of PennsylvaniaPennsylvania | $84.69 | — |
| Puerto RicoPuerto Rico | $90.89 | — |
| Rhode IslandRhode Island | $92.65 | — |
| South CarolinaSouth Carolina | $84.96 | — |
| South DakotaSouth Dakota | $89.30 | — |
| TennesseeTennessee | $83.55 | — |
| Austin, TXTexas | $93.91 | — |
| Beaumont, TXTexas | $84.14 | — |
| Brazoria, TXTexas | $89.47 | — |
| Dallas, TXTexas | $89.93 | — |
| Fort Worth, TXTexas | $89.29 | — |
| Galveston, TXTexas | $89.67 | — |
| Houston, TXTexas | $90.40 | — |
| Rest of TexasTexas | $86.68 | — |
| UtahUtah | $86.08 | — |
| VirginiaVirginia | $88.67 | — |
| Virgin Islands, VIUnited States Virgin Islands | $90.89 | — |
| VermontVermont | $88.86 | — |
| Rest of WashingtonWashington | $93.66 | — |
| King County, WAWashington | $106.09 | — |
| WisconsinWisconsin | $86.48 | — |
| West VirginiaWest Virginia | $82.09 | — |
| WyomingWyoming | $89.84 | — |
76821 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.
$80.21
$108.80
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 | $105.24 | 1 |
| AL | $81.34 | 1 |
| AR | $80.21 | 1 |
| AZ | $87.94 | 1 |
| CA | $96.30–$121.29 | 29 |
| CO | $94.39 | 1 |
| CT | $96.01 | 1 |
| DC | $103.33 | 1 |
| DE | $89.37 | 1 |
| FL | $87.94–$94.94 | 3 |
| GA | $83.30–$91.58 | 2 |
| GU | $98.68 | 1 |
| HI | $98.68 | 1 |
| IA | $83.76 | 1 |
| ID | $84.19 | 1 |
| IL | $85.18–$93.16 | 4 |
| IN | $84.67 | 1 |
| KS | $83.17 | 1 |
| KY | $82.73 | 1 |
| LA | $82.52–$86.46 | 2 |
| MA | $93.78–$103.80 | 2 |
| MD | $91.09–$103.33 | 3 |
| ME | $84.39–$89.09 | 2 |
| MI | $84.60–$88.78 | 2 |
| MN | $91.16 | 1 |
| MO | $81.02–$87.01 | 3 |
| MS | $80.64 | 1 |
| MT | $90.18 | 1 |
| NC | $85.27 | 1 |
| ND | $89.39 | 1 |
| NE | $84.26 | 1 |
| NH | $92.73 | 1 |
| NJ | $97.30–$102.29 | 2 |
| NM | $84.96 | 1 |
| NV | $90.03 | 1 |
| NY | $86.48–$105.28 | 5 |
| OH | $84.44 | 1 |
| OK | $82.81 | 1 |
| OR | $89.52–$97.54 | 2 |
| PA | $84.69–$93.56 | 2 |
| PR | $90.89 | 1 |
| RI | $92.65 | 1 |
| SC | $84.96 | 1 |
| SD | $89.30 | 1 |
| TN | $83.55 | 1 |
| TX | $84.14–$93.91 | 8 |
| UT | $86.08 | 1 |
| VA | $88.67–$103.33 | 2 |
| VI | $90.89 | 1 |
| VT | $88.86 | 1 |
| WA | $93.66–$106.09 | 2 |
| WI | $86.48 | 1 |
| WV | $82.09 | 1 |
| WY | $89.84 | 1 |
How the 76821 rate is calculated
Each of 76821’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 · 76821
RVUs × geographic indexes × conversion factor
Work0.68
0.68 RVUs× 1.000 GPCI
Practice expense1.98
1.98 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
2.7000
Conversion factor
$33.4009
Medicare rate
$90.18
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
8,805
- Code
- 76821
- Physician work
- 0.68
- Practice expense
- 1.98
- Malpractice
- 0.04
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.68 | × 1.054 | 0.7167 |
| Practice expense | 1.98 | × 1.178 | 2.3324 |
| Malpractice | 0.04 | × 1.113 | 0.0445 |
| Total RVUs | 3.0937 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$103.33
Office: (0.68 × 1.054 + 1.98 × 1.178 + 0.04 × 1.113) × $33.4009 = $103.33
Payment rules and modifiers for 76821
The CMS indicators that decide how 76821 is paid alongside other services.
CMS payment indicators · 76821
Fetal Doppler, middle cerebral artery
| 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
76821 without 26 · national office
$90.18
Fetal Doppler, middle cerebral artery
76821-26 · Professional component
$33.40
Pays only the interpretation and report.
How 76821 has changed in Washington, DC area
76821 · Office / nonfacility
$103.33
Effective 2026-10-01
The base rate is $5.01 higher than on 2025-10-01, moving from $98.32 to $103.33 (5.1%).
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
$98.32changed to$103.33
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.70 changed to 0.68
- Practice expense RVU 1.90 changed to 1.98
- Malpractice RVU 0.03 changed to 0.04
- 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.
January 1, 2025
RVU25A
$102.77changed to$98.32
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.94 changed to 1.90
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$101.10changed to$102.77
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$105.70changed to$101.10
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.93 changed to 1.94
- 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
January 1, 2023
RVU23A
$109.00changed to$105.70
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.92 changed to 1.93
- 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.
January 1, 2022
RVU22A
$111.20changed to$109.00
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.95 changed to 1.92
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$108.08changed to$111.20
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.82 changed to 1.95
- 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.
January 1, 2020
RVU20A
$109.45changed to$108.08
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.84 changed to 1.82
- Malpractice RVU 0.07 changed to 0.03
- 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.
January 1, 2019
RVU19A
$111.50changed to$109.45
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.89 changed to 1.84
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$111.26changed to$111.50
- Conversion factor 35.8887 changed to 35.9996
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$110.23changed to$111.26
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.87 changed to 1.89
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$110.19changed to$110.23
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.86 changed to 1.87
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$109.65changed to$110.19
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$110.73changed to$109.65
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.92 changed to 1.86
- Malpractice RVU 0.04 changed to 0.07
- 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.
January 1, 2014
RVU14A
$112.52changed to$110.73
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.11 changed to 1.92
- 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.
January 1, 2013
RVU13AR
Earliest loaded release: $112.52
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $103.33 | Not available in this setting | RVU26D |
| 2026-07-01 | $103.33 | Not available in this setting | RVU26C |
| 2026-04-01 | $103.33 | Not available in this setting | RVU26B |
| 2026-01-01 | $103.33 | Not available in this setting | RVU26A |
| 2025-10-01 | $98.32 | Not available in this setting | RVU25D |
| 2025-07-01 | $98.32 | Not available in this setting | RVU25C |
| 2025-04-01 | $98.32 | Not available in this setting | RVU25B |
| 2025-01-01 | $98.32 | Not available in this setting | RVU25A |
| 2024-10-01 | $102.77 | Not available in this setting | RVU24D |
| 2024-07-01 | $102.77 | Not available in this setting | RVU24C |
| 2024-04-01 | $102.77 | Not available in this setting | RVU24B |
| 2024-03-09 | $102.77 | Not available in this setting | RVU24AR |
| 2024-01-01 | $101.10 | Not available in this setting | RVU24A |
| 2023-10-01 | $105.70 | Not available in this setting | RVU23D |
| 2023-07-01 | $105.70 | Not available in this setting | RVU23C |
| 2023-04-01 | $105.70 | Not available in this setting | RVU23B |
| 2023-01-01 | $105.70 | Not available in this setting | RVU23A |
| 2022-10-01 | $109.00 | Not available in this setting | RVU22D |
| 2022-07-01 | $109.00 | Not available in this setting | RVU22C |
| 2022-04-01 | $109.00 | Not available in this setting | RVU22B |
| 2022-01-01 | $109.00 | Not available in this setting | RVU22A |
| 2021-10-01 | $111.20 | Not available in this setting | RVU21D |
| 2021-07-01 | $111.20 | Not available in this setting | RVU21C |
| 2021-04-01 | $111.20 | Not available in this setting | RVU21B |
| 2021-01-01 | $111.20 | Not available in this setting | RVU21A |
| 2020-10-01 | $108.08 | Not available in this setting | RVU20D |
| 2020-07-01 | $108.08 | Not available in this setting | RVU20C |
| 2020-04-01 | $108.08 | Not available in this setting | RVU20B |
| 2020-01-01 | $108.08 | Not available in this setting | RVU20A |
| 2019-10-01 | $109.45 | Not available in this setting | RVU19D |
| 2019-07-01 | $109.45 | Not available in this setting | RVU19C |
| 2019-04-01 | $109.45 | Not available in this setting | RVU19B |
| 2019-01-01 | $109.45 | Not available in this setting | RVU19A |
| 2018-10-01 | $111.50 | Not available in this setting | RVU18D |
| 2018-07-01 | $111.50 | Not available in this setting | RVU18C |
| 2018-04-01 | $111.50 | Not available in this setting | RVU18B |
| 2018-01-01 | $111.50 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $111.26 | Not available in this setting | RVU17D |
| 2017-07-01 | $111.26 | Not available in this setting | RVU17C |
| 2017-04-01 | $111.26 | Not available in this setting | RVU17B |
| 2017-01-01 | $111.26 | Not available in this setting | RVU17A |
| 2016-10-01 | $110.23 | Not available in this setting | RVU16D |
| 2016-07-01 | $110.23 | Not available in this setting | RVU16C |
| 2016-04-01 | $110.23 | Not available in this setting | RVU16B |
| 2016-01-01 | $110.23 | Not available in this setting | RVU16A |
| 2015-10-01 | $110.19 | Not available in this setting | RVU15D |
| 2015-07-01 | $110.19 | Not available in this setting | RVU15C |
| 2015-04-01 | $109.65 | Not available in this setting | RVU15B |
| 2015-01-01 | $109.65 | Not available in this setting | RVU15A |
| 2014-10-01 | $110.73 | Not available in this setting | RVU14D |
| 2014-07-01 | $110.73 | Not available in this setting | RVU14C |
| 2014-04-01 | $110.73 | Not available in this setting | RVU14B |
| 2014-01-01 | $110.73 | Not available in this setting | RVU14A |
| 2013-10-01 | $112.52 | Not available in this setting | RVU13D |
| 2013-07-01 | $112.52 | Not available in this setting | RVU13C |
| 2013-04-01 | $112.52 | Not available in this setting | RVU13B |
| 2013-01-01 | $112.52 | Not available in this setting | RVU13AR |
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
76821 billing questions
How does 76821 differ from 76820?
76821 is for Doppler assessment of the fetal middle cerebral artery. 76820 is for the fetal umbilical artery.
Can modifier 26 or TC be reported?
Yes. Modifier 26 identifies the professional interpretation, and TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
Does 76821 include a fetal growth ultrasound?
No. It represents the MCA Doppler assessment. A separately performed fetal growth reassessment may be reported with 76816 when supported by the documentation.
What documentation supports reporting 76821?
Document the clinical indication, the middle cerebral artery examination, Doppler findings, and the interpreting physician’s assessment. The record should make clear that the study evaluates MCA flow rather than umbilical-artery flow.
Can 76821 be reported with a biophysical profile?
It may be reported with 76818 when a biophysical profile including a nonstress test is also performed and documented as a separate service.
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
Put 76821 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet