Billing code 76825: Fetal echocardiogramMedicare rate & RVUs in Utah
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.
Medicare pays $249.29 for 76825 in the office in Utah (Utah). 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 76825 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $249.29 | Unavailable |
How the 76825 rate is calculated
Each of 76825’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 · 76825
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.63Practice expense 6.12Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76825
The CMS indicators that decide how 76825 is paid alongside other services.
CMS payment indicators · 76825
Fetal echocardiogram
| 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
76825 without 26 · national office
$261.86
Fetal echocardiogram
76825-26 · Professional component
$78.83
Pays only the interpretation and report.
76825 compared with similar codes
Compare codes
76825 vs 76826 vs 76827 vs 76811: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76826Fetal echo
- Choose 76825 for the complete fetal cardiac examination. Choose 76826 when the fetal cardiac examination is a follow-up or repeat study.
- 76827Fetal echocardiography
- 76825 reports the complete fetal cardiac ultrasound. 76827 identifies the Doppler echocardiographic portion when Doppler assessment is performed and documented.
- 76811Obstetric ultrasound
- 76811 is a detailed obstetric ultrasound examination; 76825 is a focused examination of the fetal heart.
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 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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