Billing code 76813: Nuchal translucencyMedicare rate & RVUs in Guam
Reports a first-trimester ultrasound measurement of fetal nuchal translucency for one fetus or the first fetus in a multiple gestation.
Medicare pays $124.83 for 76813 in the office in Guam (Hawaii, Guam). 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.
On this page 9 sections
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.
76813 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $124.83 | Unavailable |
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
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
| 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
76813 without 26 · national office
$115.57
Nuchal translucency
76813-26 · Professional component
$56.45
Pays only the interpretation and report.
76813 compared with similar codes
Compare codes
76813 vs 76801 vs 76814 vs 76811: national Medicare rates
Swap in your local Medicare rate.
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
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