CPT 76821
Global XXX ActiveMiddle cerebral artery echo
CPT 76821 Billing & Documentation Guide
CPT code 76821 (Middle cerebral artery echo) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.68, a non-facility practice expense RVU of 1.98, and a malpractice RVU of 0.04, a total non-facility RVU of 2.7 and facility RVU of 2.7. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $93.34, though rates vary from $80.21 to $121.29 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76821, 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 76821 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 76821 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 76821
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.68 | 0.68 |
| Practice Expense RVU | 1.98 | 1.98 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.7 | 2.7 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76821
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 | $102.51 | $102.51 | $96.3 - $121.29 | 29 |
| Florida | $91.67 | $91.67 | $87.94 - $94.94 | 3 |
| Georgia | $87.44 | $87.44 | $83.3 - $91.58 | 2 |
| Illinois | $89.25 | $89.25 | $85.18 - $93.16 | 4 |
| Michigan | $86.69 | $86.69 | $84.6 - $88.78 | 2 |
| North Carolina | $85.27 | $85.27 | $85.27 - $85.27 | 1 |
| New York | $99.38 | $99.38 | $86.48 - $105.28 | 5 |
| Ohio | $84.44 | $84.44 | $84.44 - $84.44 | 1 |
| Pennsylvania | $89.13 | $89.13 | $84.69 - $93.56 | 2 |
| Texas | $89.19 | $89.19 | $84.14 - $93.91 | 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 76821
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76821 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 |
| 76376 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76377 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76815 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76828 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 93325 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 76821
What does CPT code 76821 mean? +
CPT code 76821 represents: Middle cerebral artery echo. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76821? +
The 2026 Medicare national average non-facility payment for CPT 76821 is $93.34. Rates range from $80.21 to $121.29 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76821? +
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 76821? +
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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