Billing code 76821: Fetal DopplerMedicare rate & RVUs

Medicare pays $90.18 for 76821 nationally in the office. Local office rates run $80.21–$121.29.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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

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

109 of 109 payment localities

76821 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

Payment rules and modifiers for 76821

The CMS indicators that decide how 76821 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76821 compared with similar codes

How to choose

76820Umbilical artery Doppler

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 ultrasound

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 profile

76818 reports a fetal biophysical profile with a nonstress test. It does not represent the targeted middle cerebral artery Doppler examination reported with 76821.

Codes related to 76821

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates