$109.25
Choose 76813 for the NT measurement. Choose 76801 for a first-trimester obstetric ultrasound examination; it does not represent the NT measurement alone.
On this page
CMS RVU26D · Effective 2026-10-01
76813 Nuchal translucency Medicare reimbursement rates in Idaho
Reports a first-trimester ultrasound measurement of fetal nuchal translucency for one fetus or the first fetus in a multiple gestation. Compare 76813 office and facility rates across CMS payment localities in Idaho.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 76813 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$108.35
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Obstetric ultrasound
About 76813: First-trimester nuchal translucency ultrasound
Reports a first-trimester ultrasound measurement of fetal nuchal translucency for one fetus or the first fetus in a multiple gestation.
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.
CMS billing rules for 76813
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU1.15 · 33%
- Practice expense (office) RVU2.24 · 65%
- Malpractice RVU0.07 · 2%
788
Medicare services in 2024 · #3165 by national volume
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 compared with similar codes
Office rates for Idaho, from the same CMS release.
$70.68
76813 covers one fetus or the first fetus in a multiple gestation. 76814 covers each additional fetus whose NT is measured.
$170.77
76811 is for a detailed fetal anatomic examination. 76813 is for the first-trimester nuchal translucency measurement.
Compare 76813 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
$108.35
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 76813 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
8,781
- Code
- 76813
- Physician work
- 1.15
- Practice expense
- 2.24
- Malpractice
- 0.07
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.15 | × 1.000 | 1.1500 |
| Practice expense | 2.24 | × 0.920 | 2.0608 |
| Malpractice | 0.07 | × 0.473 | 0.0331 |
| Total RVUs | 3.2439 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$108.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.15 | 1 |
| Practice expense | 2.24 | 0.92 |
| Malpractice | 0.07 | 0.473 |
(1.15 × 1 + 2.24 × 0.92 + 0.07 × 0.473) × $33.4009 = $108.35
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,77876812,,Ob us detailed addl fetus,A,,1.74,3.98,,3.98,NA,0.10,5.82,5.82,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,77976812,26,Ob us detailed addl fetus,A,,1.74,0.74,,0.74,,0.08,2.56,2.56,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78076812,TC,Ob us detailed addl fetus,A,,0.00,3.24,,3.24,NA,0.02,3.26,3.26,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
8,78176813,,Ob us nuchal meas 1 gest,A,,1.15,2.24,,2.24,NA,0.07,3.46,3.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78276813,26,Ob us nuchal meas 1 gest,A,,1.15,0.48,,0.48,,0.06,1.69,1.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78376813,TC,Ob us nuchal meas 1 gest,A,,0.00,1.76,,1.76,NA,0.01,1.77,1.77,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
8,78476814,,Ob us nuchal meas add-on,A,,0.97,1.22,,1.22,NA,0.05,2.24,2.24,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772