$147.06
Choose 76825 for the complete fetal cardiac examination. Choose 76826 when the fetal cardiac examination is a follow-up or repeat study.
On this page
CMS RVU26D · Effective 2026-10-01
76825 Fetal echocardiogram Medicare reimbursement rates in Ohio
Reports a comprehensive ultrasound assessment of the fetal heart, commonly performed when screening findings or clinical risk raise concern about fetal cardiac structure or function. Compare 76825 office and facility rates across CMS payment localities in Ohio.
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 76825 in Ohio?
Ohio 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
$244.10
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Fetal echocardiography
About 76825: Complete fetal cardiac ultrasound
Reports a comprehensive ultrasound assessment of the fetal heart, commonly performed when screening findings or clinical risk raise concern about fetal cardiac structure or function.
This service is a detailed ultrasound assessment of the fetal heart, using real-time two-dimensional imaging with image documentation; M-mode recording may also be used. Maternal-fetal medicine specialists, pediatric cardiologists, and other qualified imaging physicians commonly perform or interpret it. A typical reason is an abnormality or concern on an obstetric screening ultrasound that warrants a focused evaluation of fetal cardiac anatomy and function.
Report 76825 for the complete fetal cardiac study, rather than a repeat or follow-up examination. The record should support the clinical reason for the study and include the images and interpretation of the fetal heart. CMS recognizes a professional component for interpretation and a technical component for the equipment and staff used to acquire the study. Report modifier 26 for the professional service or TC for the technical service when those components are billed separately; without either modifier, the code represents the global service.
CMS billing rules for 76825
- 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 RVU1.63 · 21%
- Practice expense (office) RVU6.12 · 78%
- Malpractice RVU0.09 · 1%
704
Medicare services in 2024 · #3254 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.
76825 compared with similar codes
Office rates for Ohio, from the same CMS release.
$65.49
76825 reports the complete fetal cardiac ultrasound. 76827 identifies the Doppler echocardiographic portion when Doppler assessment is performed and documented.
$171.92
76811 is a detailed obstetric ultrasound examination; 76825 is a focused examination of the fetal heart.
Compare 76825 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
Ohio →
Office / nonfacility
$244.10
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 76825 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
8,808
- Code
- 76825
- Physician work
- 1.63
- Practice expense
- 6.12
- Malpractice
- 0.09
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.63 | × 1.000 | 1.6300 |
| Practice expense | 6.12 | × 0.913 | 5.5876 |
| Malpractice | 0.09 | × 1.008 | 0.0907 |
| Total RVUs | 7.3083 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$244.10
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.63 | 1 |
| Practice expense | 6.12 | 0.913 |
| Malpractice | 0.09 | 1.008 |
(1.63 × 1 + 6.12 × 0.913 + 0.09 × 1.008) × $33.4009 = $244.10
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.
76825 billing questions
How does 76825 differ from 76826?
76825 is for the complete fetal cardiac examination. Use 76826 for a follow-up or repeat fetal cardiac examination.
Can Doppler fetal echocardiography be reported with 76825?
When a fetal Doppler echocardiographic study is also performed and documented, 76827 identifies that Doppler service. The record should support each service reported.
When should modifier 26 or TC be used?
Use modifier 26 when billing only the physician's interpretation, or TC when billing only the technical service, including equipment and staff. Without either modifier, 76825 represents the global service.
What documentation supports reporting 76825?
Document the clinical reason for the focused fetal heart evaluation, the imaging performed, the findings, and the interpretation. Retain image documentation supporting the examination.
Is 76825 for a routine obstetric anatomy scan?
No. It reports a focused fetal cardiac ultrasound; a detailed obstetric anatomy examination is a different service, reported with 76811 when that examination is 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 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.
8,80576821,,Middle cerebral artery echo,A,,0.68,1.98,,1.98,NA,0.04,2.70,2.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.47,3.47,0.05
8,80676821,26,Middle cerebral artery echo,A,,0.68,0.29,,0.29,,0.03,1.00,1.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,80776821,TC,Middle cerebral artery echo,A,,0.00,1.69,,1.69,NA,0.01,1.70,1.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.18,3.18,0.02
8,80876825,,Echo exam of fetal heart,A,,1.63,6.12,,6.12,NA,0.09,7.84,7.84,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,17.29,17.29,0.15
8,80976825,26,Echo exam of fetal heart,A,,1.63,0.67,,0.67,,0.06,2.36,2.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,81076825,TC,Echo exam of fetal heart,A,,0.00,5.45,,5.45,NA,0.03,5.48,5.48,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.62,16.62,0.09
8,81176826,,Echo exam of fetal heart,A,,0.81,3.88,,3.88,NA,0.05,4.74,4.74,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,7.60,7.60,0.07
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703