CPT 76828
Global XXX ActiveEcho exam of fetal heart
CPT 76828 Billing & Documentation Guide
CPT code 76828 (Echo exam of fetal heart) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.55, a non-facility practice expense RVU of 0.9, and a malpractice RVU of 0.03, a total non-facility RVU of 1.48 and facility RVU of 1.48. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $50.98, though rates vary from $44.71 to $64.28 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76828, 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 76828 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 76828 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 76828
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.55 | 0.55 |
| Practice Expense RVU | 0.9 | 0.9 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 1.48 | 1.48 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76828
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 | $55.14 | $55.14 | $52.17 - $64.28 | 29 |
| Florida | $50.48 | $50.48 | $48.61 - $52.2 | 3 |
| Georgia | $48.28 | $48.28 | $46.38 - $50.17 | 2 |
| Illinois | $49.4 | $49.4 | $47.38 - $51.15 | 4 |
| Michigan | $48.01 | $48.01 | $46.95 - $49.07 | 2 |
| North Carolina | $47.06 | $47.06 | $47.06 - $47.06 | 1 |
| New York | $54.14 | $54.14 | $47.63 - $57.15 | 5 |
| Ohio | $46.83 | $46.83 | $46.83 - $46.83 | 1 |
| Pennsylvania | $49.05 | $49.05 | $46.91 - $51.19 | 2 |
| Texas | $49 | $49 | $46.66 - $51.1 | 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 76828
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76828 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 |
| 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 |
| 76377 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 76828
What does CPT code 76828 mean? +
CPT code 76828 represents: Echo exam of fetal heart. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76828? +
The 2026 Medicare national average non-facility payment for CPT 76828 is $50.98. Rates range from $44.71 to $64.28 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76828? +
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 76828? +
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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