CPT code 76821: Fetal Doppler, middle cerebral artery2026 Medicare rate & RVUs in Vermont

Reports fetal Doppler assessment of the middle cerebral artery, used chiefly to evaluate fetal anemia through blood-flow velocity measurements.

CMS RVU26DEffective Oct 1, 2026One payment locality807 Medicare services in 2024

In Vermont, Medicare pays $88.86 for 76821 in the office.

$88.86Office (non-facility)
Not available in this settingHospital or facility
−1.5%vs the national office rate ($90.18)

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.

We’ll open 76821 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 76821 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Vermont 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. Vermont pays $88.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

76821 in Vermont vs other payment areas
  1. Vermont · this page$88.86
  2. Los Angeles, CA · California$102.77+$13.91
  3. Washington, DC area · District of Columbia$103.33+$14.47
  4. Miami, FL · Florida$94.94+$6.08
  5. Chicago, IL · Illinois$92.40+$3.54
  6. Manhattan, NY · New York$103.13+$14.27
  7. Alaska · Alaska$105.24+$16.38

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

76821 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$81.34—
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—

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
76821 office rate range by state
State / territoryOffice rate rangeLocalities
AK$105.241
AL$81.341
AR$80.211
AZ$87.941
CA$96.30–$121.2929
CO$94.391
CT$96.011
DC$103.331
DE$89.371
FL$87.94–$94.943
GA$83.30–$91.582
GU$98.681
HI$98.681
IA$83.761
ID$84.191
IL$85.18–$93.164
IN$84.671
KS$83.171
KY$82.731
LA$82.52–$86.462
MA$93.78–$103.802
MD$91.09–$103.333
ME$84.39–$89.092
MI$84.60–$88.782
MN$91.161
MO$81.02–$87.013
MS$80.641
MT$90.181
NC$85.271
ND$89.391
NE$84.261
NH$92.731
NJ$97.30–$102.292
NM$84.961
NV$90.031
NY$86.48–$105.285
OH$84.441
OK$82.811
OR$89.52–$97.542
PA$84.69–$93.562
PR$90.891
RI$92.651
SC$84.961
SD$89.301
TN$83.551
TX$84.14–$93.918
UT$86.081
VA$88.67–$103.332
VI$90.891
VT$88.861
WA$93.66–$106.092
WI$86.481
WV$82.091
WY$89.841

See 76821 in every payment locality

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

Office or facility?

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 76821 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.68× 1.0000.6800
Practice expense1.98× 0.9901.9602
Malpractice0.04× 0.5060.0202
Total RVUs2.6604
Conversion factor× 33.4009

Office rate, Vermont$88.86

Office: (0.68 × 1 + 1.98 × 0.99 + 0.04 × 0.506) × $33.4009 = $88.86

Open 76821 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

How 76821 has changed in Vermont

76821 · Office / nonfacility

$88.86

Effective 2026-10-01

The base rate is $4.69 higher than on 2025-10-01, moving from $84.17 to $88.86 (5.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $84.17changed to$88.86

    • 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
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $87.94changed to$84.17

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.94 changed to 1.90

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $86.51changed to$87.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $89.48changed to$86.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.93 changed to 1.94
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $91.33changed to$89.48

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.92 changed to 1.93
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $93.13changed to$91.33

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.95 changed to 1.92

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $92.10changed to$93.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.82 changed to 1.95
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $94.04changed to$92.10

    • 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
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $95.76changed to$94.04

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.89 changed to 1.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $95.24changed to$95.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $93.99changed to$95.24

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.89
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $93.97changed to$93.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.86 changed to 1.87

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $93.50changed to$93.97

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $95.15changed to$93.50

    • 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
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$95.15

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$88.86Not available in this settingRVU26D
2026-07-01$88.86Not available in this settingRVU26C
2026-04-01$88.86Not available in this settingRVU26B
2026-01-01$88.86Not available in this settingRVU26A
2025-10-01$84.17Not available in this settingRVU25D
2025-07-01$84.17Not available in this settingRVU25C
2025-04-01$84.17Not available in this settingRVU25B
2025-01-01$84.17Not available in this settingRVU25A
2024-10-01$87.94Not available in this settingRVU24D
2024-07-01$87.94Not available in this settingRVU24C
2024-04-01$87.94Not available in this settingRVU24B
2024-03-09$87.94Not available in this settingRVU24AR
2024-01-01$86.51Not available in this settingRVU24A
2023-10-01$89.48Not available in this settingRVU23D
2023-07-01$89.48Not available in this settingRVU23C
2023-04-01$89.48Not available in this settingRVU23B
2023-01-01$89.48Not available in this settingRVU23A
2022-10-01$91.33Not available in this settingRVU22D
2022-07-01$91.33Not available in this settingRVU22C
2022-04-01$91.33Not available in this settingRVU22B
2022-01-01$91.33Not available in this settingRVU22A
2021-10-01$93.13Not available in this settingRVU21D
2021-07-01$93.13Not available in this settingRVU21C
2021-04-01$93.13Not available in this settingRVU21B
2021-01-01$93.13Not available in this settingRVU21A
2020-10-01$92.10Not available in this settingRVU20D
2020-07-01$92.10Not available in this settingRVU20C
2020-04-01$92.10Not available in this settingRVU20B
2020-01-01$92.10Not available in this settingRVU20A
2019-10-01$94.04Not available in this settingRVU19D
2019-07-01$94.04Not available in this settingRVU19C
2019-04-01$94.04Not available in this settingRVU19B
2019-01-01$94.04Not available in this settingRVU19A
2018-10-01$95.76Not available in this settingRVU18D
2018-07-01$95.76Not available in this settingRVU18C
2018-04-01$95.76Not available in this settingRVU18B
2018-01-01$95.76Not available in this settingRVU18AR1
2017-10-01$95.24Not available in this settingRVU17D
2017-07-01$95.24Not available in this settingRVU17C
2017-04-01$95.24Not available in this settingRVU17B
2017-01-01$95.24Not available in this settingRVU17A
2016-10-01$93.99Not available in this settingRVU16D
2016-07-01$93.99Not available in this settingRVU16C
2016-04-01$93.99Not available in this settingRVU16B
2016-01-01$93.99Not available in this settingRVU16A
2015-10-01$93.97Not available in this settingRVU15D
2015-07-01$93.97Not available in this settingRVU15C
2015-04-01$93.50Not available in this settingRVU15B
2015-01-01$93.50Not available in this settingRVU15A
2014-10-01$95.15Not available in this settingRVU14D
2014-07-01$95.15Not available in this settingRVU14C
2014-04-01$95.15Not available in this settingRVU14B
2014-01-01$95.15Not available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 76821 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for 76821PPRRVU2026_Oct_nonQPP.csv, line 8,805 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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