$65.67–$72.38
Use 76827 for a complete fetal Doppler echocardiographic study. Use 76828 when the Doppler fetal cardiac assessment is repeat or follow-up.
On this page
CMS RVU26D · Effective 2026-10-01
76828 Fetal echo Medicare reimbursement rates in Pennsylvania
Reports repeat or follow-up Doppler assessment of fetal cardiac blood flow when a prior fetal echocardiographic evaluation requires reassessment. Compare 76828 office and facility rates across CMS payment localities in Pennsylvania.
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 76828 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$46.91–$51.19
2 of 2 localities have a supported rate.
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 76828: Follow-up fetal cardiac Doppler study
Reports repeat or follow-up Doppler assessment of fetal cardiac blood flow when a prior fetal echocardiographic evaluation requires reassessment.
This service is a repeat or follow-up Doppler evaluation of the fetal heart, using pulsed-wave and/or continuous-wave Doppler with spectral display to assess cardiac blood-flow patterns. It may be performed by a fetal cardiologist, pediatric cardiologist, radiologist, or maternal-fetal medicine specialist in an ultrasound or hospital setting. The study addresses a previously evaluated fetal cardiac concern, rather than serving as a routine obstetric survey or a Doppler study limited to a fetal artery.
Select this code when the documented service is follow-up or repeat fetal cardiac Doppler imaging; use the complete Doppler study code for an initial complete Doppler examination. The report should identify the clinical reason for reassessment and include the Doppler findings and interpretation. The service has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 76828
- 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 RVU0.55 · 37%
- Practice expense (office) RVU0.90 · 61%
- Malpractice RVU0.03 · 2%
217
Medicare services in 2024 · #4257 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.
76828 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$147.60–$164.44
76826 describes follow-up or repeat real-time fetal echocardiography with M-mode when performed; 76828 describes the follow-up Doppler portion.
$42.76–$46.72
76820 assesses umbilical artery flow. 76828 assesses fetal cardiac Doppler findings, not a Doppler examination limited to the umbilical artery.
Compare 76828 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$51.19
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$46.91
Facility
Unavailable
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76828 billing questions
How does this differ from 76827?
76828 is for repeat or follow-up fetal cardiac Doppler imaging. 76827 describes the complete Doppler fetal echocardiographic study.
How does this differ from 76826?
76826 covers follow-up or repeat fetal echocardiography using real-time imaging and M-mode when performed. 76828 identifies the follow-up Doppler assessment with spectral display.
Can 76828 be reported with 76826?
They describe different aspects of a follow-up fetal echocardiographic examination: real-time imaging and M-mode under 76826, and Doppler assessment under 76828. The documentation should support both services.
Which modifiers identify the professional and technical portions?
Append modifier 26 for the professional interpretation or modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports follow-up Doppler reporting?
Document the reason for reassessment, the fetal cardiac Doppler evaluation performed, the spectral findings, and the interpretation. The record should support that this was a repeat or follow-up Doppler study.
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.
8,81476827,,Echo exam of fetal heart,A,,0.57,1.49,,1.49,NA,0.03,2.09,2.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.40,3.40,0.05
8,81576827,26,Echo exam of fetal heart,A,,0.57,0.23,,0.23,,0.02,0.82,0.82,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,81676827,TC,Echo exam of fetal heart,A,,0.00,1.26,,1.26,NA,0.01,1.27,1.27,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.17,3.17,0.03
8,81776828,,Echo exam of fetal heart,A,,0.55,0.90,,0.90,NA,0.03,1.48,1.48,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.38,3.38,0.07
8,81876828,26,Echo exam of fetal heart,A,,0.55,0.23,,0.23,,0.02,0.80,0.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,81976828,TC,Echo exam of fetal heart,A,,0.00,0.67,,0.67,NA,0.01,0.68,0.68,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.15,3.15,0.05
8,82076830,,Transvaginal us non-ob,A,,0.67,2.79,,2.79,NA,0.06,3.52,3.52,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.43,3.43,0.07