CPT code 76826: Fetal echo, follow-up or repeat study2026 Medicare rate & RVUs in Texas
Reports repeat or follow-up two-dimensional fetal cardiac imaging, with or without M-mode, to reassess a previously evaluated fetal heart.
Medicare pays $146.54–$165.70 for 76826 in the office in Texas, from Beaumont, TX to Austin, TX. 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 76826 covers
Code 76826 represents a repeat or follow-up ultrasound examination focused on the fetal heart, using real-time two-dimensional imaging and M-mode when performed. A fetal cardiologist, maternal-fetal medicine specialist, or radiologist may perform or interpret the study in an office, hospital, or imaging setting. Typical reasons include reassessing a cardiac finding identified on an earlier fetal echocardiogram or completing a cardiac assessment that required follow-up.
Choose this code for a repeat or follow-up cardiac imaging study, rather than a complete fetal echocardiogram or a routine obstetric growth examination. The report should identify the reason for the repeat, the cardiac structures or findings reassessed, and the interpretation. For physician interpretation alone, append modifier 26; for the equipment and staff portion alone, append modifier TC. Without either modifier, the claim represents the global service. Spectral Doppler follow-up, when performed and documented, is represented separately by 76828.
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 76826 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$146.54 to $165.70
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $165.70 | Unavailable |
| Beaumont, TX | $146.54 | Unavailable |
| Brazoria, TX | $157.00 | Unavailable |
| Dallas, TX | $157.81 | Unavailable |
| Fort Worth, TX | $156.53 | Unavailable |
| Galveston, TX | $157.34 | Unavailable |
| Houston, TX | $158.26 | Unavailable |
| Rest of Texas | $151.55 | Unavailable |
How the 76826 rate is calculated
Each of 76826’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 · 76826
RVUs × geographic indexes × conversion factor
Work0.81
0.81 RVUs× 1.000 GPCI
Practice expense3.88
3.88 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
4.7400
Conversion factor
$33.4009
Medicare rate
$158.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76826
The CMS indicators that decide how 76826 is paid alongside other services.
CMS payment indicators · 76826
Fetal echo, follow-up or repeat study
| 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
76826 without 26 · national office
$158.32
Fetal echo, follow-up or repeat study
76826-26 · Professional component
$39.41
Pays only the interpretation and report.
76826 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76825Fetal echocardiogramComplete cardiac study
- Use 76825 for a complete fetal echocardiographic examination; use 76826 when the cardiac imaging is a repeat or follow-up study.
- 76828Fetal echoFollow-up Doppler
- 76828 reports follow-up or repeat fetal spectral Doppler echocardiography. It may accompany 76826 when that Doppler evaluation is also performed and documented.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 is an obstetric follow-up examination per fetus, commonly used to reassess fetal growth or development. It is not the focused repeat fetal cardiac study represented by 76826.
76826 billing questions
How does 76826 differ from 76825?
76826 is for repeat or follow-up fetal cardiac imaging. Use 76825 for a complete fetal echocardiographic examination.
Can 76826 be reported with 76828?
Yes, when the repeat or follow-up examination includes a separately performed and documented spectral Doppler evaluation. Code 76826 represents the two-dimensional imaging portion; 76828 represents follow-up Doppler echocardiography.
Which modifier identifies the interpretation only?
Append modifier 26 when billing only the physician’s interpretation. Modifier TC identifies the technical portion; no component modifier represents the global service.
What documentation supports reporting 76826?
Document why fetal cardiac imaging was repeated, what cardiac findings or structures were reassessed, and the study results and interpretation.
Is 76826 used for a routine fetal growth follow-up?
No. It represents follow-up imaging focused on the fetal heart; a routine obstetric follow-up ultrasound addresses a different examination purpose.
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
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