Billing code 76813: Nuchal translucencyMedicare rate & RVUs

Reports a first-trimester ultrasound measurement of fetal nuchal translucency for one fetus or the first fetus in a multiple gestation.

CMS RVU26DEffective Oct 1, 2026109 payment localities788 Medicare services in 2024

Medicare pays $115.57 for 76813 nationally in the office. Local office rates run $103.88–$151.78.

Medicare rate · 76813

Nuchal translucency

Swap in your local Medicare rate.

Work RVUs
1.15
Total RVUs
3.46
Global days
XXX

National rate · 2026

$115.57

Office setting, before claim adjustments.

See every locality for 76813 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 76813 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 76813 covers

This obstetric ultrasound measures the fluid-filled space at the back of the fetal neck during first-trimester screening for chromosomal abnormalities. An ultrasound technologist or physician acquires the images, and an interpreting physician—often an obstetrician, radiologist, or maternal-fetal medicine specialist—documents the measurement. The scan may use a transabdominal or transvaginal approach, depending on the clinical circumstances and image quality.

Report 76813 for one fetus or the first fetus in a multiple gestation; report 76814 for each additional gestation when its measurement is performed. Documentation should support the number of fetuses assessed, the nuchal translucency measurement, image acquisition, and the physician’s interpretation. CMS recognizes professional and technical components: bill modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier for the global service. The professional and technical components have separate payment rates.

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 76813 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$103.88 to $151.78

$103.88$127.83$151.78
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

76813 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$105.20Unavailable
Alaska*$138.59Unavailable
Arizona$112.91Unavailable
Arkansas$103.88Unavailable
Atlanta$117.35Unavailable
Austin$119.72Unavailable
Bakersfield$122.57Unavailable
Baltimore/Surr. Cntys$122.20Unavailable
Beaumont$108.67Unavailable
Brazoria$114.69Unavailable

76813 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.

$103.88

$138.59

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
76813 office rate range by state
State / territoryOffice rate rangeLocalities
AK$138.591
AL$105.201
AR$103.881
AZ$112.911
CA$122.32–$151.7829
CO$120.301
CT$122.591
DC$131.221
DE$114.631
FL$113.45–$122.213
GA$107.94–$117.352
GU$124.831
HI$124.831
IA$107.801
ID$108.351
IL$110.37–$119.664
IN$108.901
KS$107.221
KY$107.061
LA$106.86–$111.472
MA$119.67–$131.402
MD$116.66–$131.223
ME$108.70–$114.032
MI$109.36–$114.552
MN$116.091
MO$105.18–$111.983
MS$104.561
MT$115.561
NC$109.711
ND$114.181
NE$108.351
NH$118.341
NJ$124.21–$130.122
NM$109.831
NV$115.251
NY$111.13–$134.175
OH$109.081
OK$107.041
OR$114.57–$123.892
PA$109.30–$119.782
PR$116.361
RI$118.511
SC$109.531
SD$114.011
TN$107.681
TX$108.67–$119.728
UT$110.841
VA$113.61–$131.222
VI$116.361
VT$113.661
WA$119.47–$134.042
WI$110.811
WV$106.771
WY$114.961

How the 76813 rate is calculated

Each of 76813’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 · 76813

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.15Practice expense 2.24Malpractice 0.07

3.4600 adjusted RVUs×$33.4009 conversion factor=$115.57

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 76813

The CMS indicators that decide how 76813 is paid alongside other services.

CMS payment indicators · 76813

Nuchal translucency

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

76813 without 26 · national office

$115.57

Nuchal translucency

76813-26 · Professional component

$56.45

Pays only the interpretation and report.

When to use modifier 26

76813 compared with similar codes

Compare codes

76813 vs 76801 vs 76814 vs 76811: national Medicare rates

Swap in your local Medicare rate.

  • 76813
    Nuchal translucency · 1.15 wRVU
    $115.57
  • 76801
    Obstetric ultrasound · 0.97 wRVU
    $116.90+$1.33
  • 76814
    Nuchal translucency · 0.97 wRVU
    $74.82−$40.75
  • 76811
    Obstetric ultrasound · 1.85 wRVU
    $182.03+$66.46

How to choose

76801Obstetric ultrasound
Choose 76813 for the NT measurement. Choose 76801 for a first-trimester obstetric ultrasound examination; it does not represent the NT measurement alone.
76814Nuchal translucency
76813 covers one fetus or the first fetus in a multiple gestation. 76814 covers each additional fetus whose NT is measured.
76811Obstetric ultrasound
76811 is for a detailed fetal anatomic examination. 76813 is for the first-trimester nuchal translucency measurement.

76813 billing questions

How does 76813 differ from 76801?

76813 reports the first-trimester nuchal translucency measurement. 76801 is for a first-trimester obstetric ultrasound examination, rather than the specific NT measurement.

How is 76813 used for a multiple gestation?

Report 76813 for the first fetus assessed and 76814 for each additional fetus with a separately performed NT measurement.

Can the professional and technical services be billed separately?

Yes. Use modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff; billing without either modifier represents the global service.

What documentation supports 76813?

The record should identify the fetus assessed and include the NT measurement, supporting images, and the interpreting physician’s findings.

Does 76813 represent a complete first-trimester anatomy survey?

No. It represents the nuchal translucency measurement; use 76801 when a complete first-trimester obstetric ultrasound examination is performed and documented.

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 76813PPRRVU2026_Oct_nonQPP.csv, line 8,781 (RVU26D)

Open CMS sourceHow we calculate rates

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