CPT code 76828: Fetal echo2026 Medicare rate & RVUs in Texas
Reports repeat or follow-up Doppler assessment of fetal cardiac blood flow when a prior fetal echocardiographic evaluation requires reassessment.
Medicare pays $46.66–$51.10 for 76828 in the office in Texas, from Beaumont to Austin. 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 76828 covers
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.
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 76828 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$46.66 to $51.10
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $51.10 | Unavailable |
| Beaumont | $46.66 | Unavailable |
| Brazoria | $49.09 | Unavailable |
| Dallas | $49.34 | Unavailable |
| Fort Worth | $49.05 | Unavailable |
| Galveston | $49.20 | Unavailable |
| Houston | $49.75 | Unavailable |
| Rest Of Texas | $47.80 | Unavailable |
How the 76828 rate is calculated
Each of 76828’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 · 76828
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense0.90
0.90 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.4800
Conversion factor
$33.4009
Medicare rate
$49.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76828
The CMS indicators that decide how 76828 is paid alongside other services.
CMS payment indicators · 76828
Fetal echo
| 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
76828 without 26 · national office
$49.43
Fetal echo
76828-26 · Professional component
$26.72
Pays only the interpretation and report.
76828 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76827Fetal echocardiography
- Use 76827 for a complete fetal Doppler echocardiographic study. Use 76828 when the Doppler fetal cardiac assessment is repeat or follow-up.
- 76826Fetal echo
- 76826 describes follow-up or repeat real-time fetal echocardiography with M-mode when performed; 76828 describes the follow-up Doppler portion.
- 76820Umbilical artery Doppler
- 76820 assesses umbilical artery flow. 76828 assesses fetal cardiac Doppler findings, not a Doppler examination limited to the umbilical artery.
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 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
Show the CMS file lines behind this rate
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