CPT 76814Radiology

Ob us nuchal meas add-on

CPT code 76814 is for measuring the nuchal translucency (fluid at the back of a baby's neck) during a prenatal ultrasound, which helps screen for chromosomal abnormalities like Down syndrome. This is an add-on code that can only be billed alongside a complete obstetric ultrasound.

Showing rates for

National Average

Base Medicare rate

$71.16

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.99

PE RVU (NF)

1.18

MP RVU

0.03

Total RVU

2.2

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Never bill 76814 as a standalone code; it must always be reported with a primary OB ultrasound code (76801, 76805, 76811, or 76813)
Impact: Prevents automatic denial; standalone billing results in 100% payment denial
Verify gestational age is between 11+0 and 13+6 weeks and document crown-rump length measurement to prove appropriate timing
Impact: Measurements outside this window are not medically appropriate and will be denied, losing $71.16 in revenue
Ensure documentation includes the actual NT measurement in millimeters, fetal position, image quality assessment, and adherence to standardized measurement technique
Impact: Incomplete documentation is the second most common denial reason; proper documentation protects $71.16 reimbursement
Maintain current NT scanning credentials (FMF or equivalent) and include credentialing documentation in provider files for audit purposes
Impact: Lack of proper credentials can result in recoupment of all 76814 payments during audit, potentially thousands of dollars
Bill the facility and non-facility rates correctly based on place of service; both are $71.16 for 2025 but verify LCD requirements
Impact: Ensures accurate payment at $71.16; incorrect POS codes may trigger payment delays or adjustments
When billing with 76801 or 76805, ensure the complete ultrasound documentation is separate from the NT measurement documentation to avoid bundling issues
Impact: Clear separation prevents modifier 59 denials and protects the full add-on payment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 76814 in 2025?

The 2025 Medicare national average reimbursement for CPT 76814 is $71.16 for both facility and non-facility settings. This rate is based on 2.2 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT code 76814 be billed alone without another ultrasound code?

No, CPT 76814 is an add-on code and cannot be billed standalone. It must always be reported with a primary obstetric ultrasound code such as 76801, 76805, 76811, or 76813. Standalone billing will result in automatic denial.

What gestational age is required to bill CPT 76814?

CPT 76814 should only be billed when nuchal translucency measurement is performed between 11 weeks 0 days and 13 weeks 6 days of gestation. Documentation must include crown-rump length to verify appropriate timing. Measurements outside this window are not medically appropriate.

What training is required to bill CPT code 76814?

Providers must have specialized training and certification in nuchal translucency measurement, typically through the Fetal Medicine Foundation (FMF) or equivalent credentialing program. Documentation of credentials, ongoing quality review, and adherence to standardized measurement protocols is required for compliant billing.

How many RVUs is CPT code 76814 worth in 2025?

CPT 76814 has 2.2 total RVUs in 2025, comprised of 0.99 work RVUs, 1.18 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs.

What documentation is needed to support billing CPT 76814?

Required documentation includes gestational age verification (11-14 weeks), crown-rump length measurement, NT measurement in millimeters, image quality notation, proper sagittal plane alignment, caliper placement technique, evidence of provider NT credentials, and documentation that a complete obstetric ultrasound was also performed.

What are the most common denial reasons for CPT 76814?

The most common denials are: billing 76814 without a primary ultrasound code, gestational age outside the 11-14 week window, lack of NT measurement training documentation, and insufficient documentation of measurement technique or medical necessity for screening.