CPT code 76821: Fetal Doppler, middle cerebral artery2026 Medicare rate & RVUs in Illinois
Reports fetal Doppler assessment of the middle cerebral artery, used chiefly to evaluate fetal anemia through blood-flow velocity measurements.
Medicare pays $85.18–$93.16 for 76821 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. 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 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.
Where 76821 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$85.18 to $93.16
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $92.40 | Unavailable |
| East St. Louis, IL | $86.25 | Unavailable |
| Rest of Illinois | $85.18 | Unavailable |
| Suburban Chicago, IL | $93.16 | Unavailable |
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.
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.
76821 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76820Umbilical artery DopplerFetal Doppler velocimetry
- Choose 76821 for Doppler assessment of the fetal middle cerebral artery; choose 76820 for the fetal umbilical artery. If both vessels are examined, document each study.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 reports a follow-up fetal ultrasound assessment, not MCA Doppler velocimetry. A separately performed growth reassessment and MCA Doppler may be reported together when documented.
- 76818Fetal biophysical profileWith nonstress test
- 76818 reports a fetal biophysical profile with a nonstress test. It does not represent the targeted middle cerebral artery Doppler examination reported with 76821.
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