CPT 76818
Global XXX ActiveFetal biophys profile w/nst
CPT 76818 Billing & Documentation Guide
CPT code 76818 (Fetal biophys profile w/nst) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.02, a non-facility practice expense RVU of 2.56, and a malpractice RVU of 0.07, a total non-facility RVU of 3.65 and facility RVU of 3.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $126, though rates vary from $108.72 to $162.37 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76818, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 76818 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 76818 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 76818
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.02 | 1.02 |
| Practice Expense RVU | 2.56 | 2.56 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 3.65 | 3.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76818
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $137.74 | $137.74 | $129.62 - $162.37 | 29 |
| Florida | $124.41 | $124.41 | $119.33 - $128.99 | 3 |
| Georgia | $118.49 | $118.49 | $113.13 - $123.85 | 2 |
| Illinois | $121.28 | $121.28 | $115.79 - $126.27 | 4 |
| Michigan | $117.65 | $117.65 | $114.78 - $120.52 | 2 |
| North Carolina | $115.34 | $115.34 | $115.34 - $115.34 | 1 |
| New York | $134.25 | $134.25 | $116.94 - $142.26 | 5 |
| Ohio | $114.49 | $114.49 | $114.49 - $114.49 | 1 |
| Pennsylvania | $120.63 | $120.63 | $114.77 - $126.48 | 2 |
| Texas | $120.61 | $120.61 | $114.05 - $126.67 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 76818
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76818 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0689T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0690T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0694T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 51701 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 51702 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 59025 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 76375 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76376 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 76818
What does CPT code 76818 mean? +
CPT code 76818 represents: Fetal biophys profile w/nst. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76818? +
The 2026 Medicare national average non-facility payment for CPT 76818 is $126. Rates range from $108.72 to $162.37 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76818? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 76818? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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