CPT code 76513: Eye ultrasound, anterior segment2026 Medicare rate & RVUs in North Dakota

Reports diagnostic ultrasound of the eye’s anterior segment, often used to assess structures such as the iris, angle, or ciliary body.

CMS RVU26DEffective Oct 1, 2026One payment locality11K Medicare services in 2024

In North Dakota, Medicare pays $76.09 for 76513 in the office.

$76.09Office (non-facility)
Not available in this settingHospital or facility
−0.5%vs the national office rate ($76.49)

Check a contract rate as a % of Medicare · 76513 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 76513 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 76513 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 76513 covers

This diagnostic study uses ultrasound to image the front portion of the eye, including structures that may be difficult to assess through the cornea or with routine examination. It is commonly performed in ophthalmology practices by trained imaging staff, with the ophthalmologist interpreting the images and documenting the findings. Ultrasound biomicroscopy is a familiar application when detailed anterior-segment imaging is needed, such as evaluating the angle or ciliary body.

Report the service when the study and interpretation address the anterior segment, rather than posterior-segment imaging, corneal thickness, or ocular biometry. Documentation should identify the clinical reason, eye examined, imaging findings, and interpretation. The code may be billed globally or as a professional component with modifier 26 or a technical component with modifier TC. For bilateral studies, CMS pays each side separately at 100%. When multiple ophthalmology diagnostic procedures are performed, the multiple-procedure reduction applies to the technical component.

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.

How North Dakota compares for 76513

Across 109 of 109 payment localities, the office rate for 76513 runs from $68.25 in Arkansas to $103.15 in San Benito County, CA. North Dakota pays $76.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

76513 in North Dakota vs other payment areas
  1. North Dakota · this page$76.09
  2. Los Angeles, CA · California$87.34+$11.25
  3. Washington, DC area · District of Columbia$87.62+$11.53
  4. Miami, FL · Florida$79.81+$3.72
  5. Chicago, IL · Illinois$77.77+$1.68
  6. Manhattan, NY · New York$87.23+$11.14
  7. Alaska · Alaska$89.69+$13.60

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

76513 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$69.18—
ArkansasArkansas$68.25—
ArizonaArizona$74.65—
Bakersfield, CACalifornia$81.99—
Chico, CACalifornia$81.90—
El Centro, CACalifornia$81.90—
Fresno, CACalifornia$81.90—
Hanford, CACalifornia$81.90—

76513 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$68.25

$92.53

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
76513 office rate range by state
State / territoryOffice rate rangeLocalities
AK$89.691
AL$69.181
AR$68.251
AZ$74.651
CA$81.90–$103.1529
CO$80.171
CT$81.341
DC$87.621
DE$75.851
FL$74.36–$79.813
GA$70.56–$77.582
GU$83.891
HI$83.891
IA$71.321
ID$71.651
IL$71.98–$78.664
IN$72.051
KS$70.771
KY$70.201
LA$70.01–$73.272
MA$79.64–$88.112
MD$77.30–$87.623
ME$71.75–$75.742
MI$71.69–$74.982
MN$77.651
MO$68.73–$73.803
MS$68.511
MT$76.491
NC$72.491
ND$76.091
NE$71.751
NH$78.711
NJ$82.50–$86.752
NM$71.961
NV$76.431
NY$73.48–$88.935
OH$71.611
OK$70.331
OR$76.07–$82.862
PA$71.85–$79.272
PR$77.101
RI$78.641
SC$72.121
SD$76.041
TN$71.071
TX$71.39–$79.718
UT$73.051
VA$75.34–$87.622
VI$77.101
VT$75.601
WA$79.56–$90.092
WI$73.671
WV$69.431
WY$76.311

See 76513 in every payment locality

How the 76513 rate is calculated

Each of 76513’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 · 76513

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense1.68

1.68 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

2.2900

Conversion factor

$33.4009

Medicare rate

$76.49

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,715

Code
76513
Physician work
0.59
Practice expense
1.68
Malpractice
0.02

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 76513 in North Dakota
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense1.68× 1.0001.6800
Malpractice0.02× 0.4060.0081
Total RVUs2.2781
Conversion factor× 33.4009

Office rate, North Dakota$76.09

Office: (0.59 × 1 + 1.68 × 1 + 0.02 × 0.406) × $33.4009 = $76.09

Open 76513 in the RVU calculator

Payment rules and modifiers for 76513

The CMS indicators that decide how 76513 is paid alongside other services.

CMS payment indicators · 76513

Eye ultrasound, anterior segment

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures7Diagnostic ophthalmology reduction applies to the technical component.
Bilateral (modifier 50)3Each side paid at 100% (no 150% cap).
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

76513 without 26 · national office

$76.49

Eye ultrasound, anterior segment

76513-26 · Professional component

$32.40

Pays only the interpretation and report.

When to use modifier 26

How 76513 has changed in North Dakota

76513 · Office / nonfacility

$76.09

Effective 2026-10-01

The base rate is $4.27 higher than on 2025-10-01, moving from $71.82 to $76.09 (5.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $71.82changed to$76.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.59
    • Practice expense RVU 1.61 changed to 1.68
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.58changed to$71.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.63 changed to 1.61

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $73.36changed to$74.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $75.55changed to$73.36

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.62 changed to 1.63
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $77.12changed to$75.55

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $79.51changed to$77.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.67 changed to 1.62

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $101.04changed to$79.51

    • Conversion factor 36.0896 changed to 34.8931
    • Work RVU 0.66 changed to 0.60
    • Practice expense RVU 2.13 changed to 1.67
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $99.86changed to$101.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.10 changed to 2.13
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $97.59changed to$99.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.04 changed to 2.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $96.22changed to$97.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.01 changed to 2.04
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $95.99changed to$96.22

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $97.06changed to$95.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.03 changed to 2.01

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $96.58changed to$97.06

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $96.75changed to$96.58

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $99.36changed to$96.75

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.25 changed to 2.03
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $99.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$76.09Not available in this settingRVU26D
2026-07-01$76.09Not available in this settingRVU26C
2026-04-01$76.09Not available in this settingRVU26B
2026-01-01$76.09Not available in this settingRVU26A
2025-10-01$71.82Not available in this settingRVU25D
2025-07-01$71.82Not available in this settingRVU25C
2025-04-01$71.82Not available in this settingRVU25B
2025-01-01$71.82Not available in this settingRVU25A
2024-10-01$74.58Not available in this settingRVU24D
2024-07-01$74.58Not available in this settingRVU24C
2024-04-01$74.58Not available in this settingRVU24B
2024-03-09$74.58Not available in this settingRVU24AR
2024-01-01$73.36Not available in this settingRVU24A
2023-10-01$75.55Not available in this settingRVU23D
2023-07-01$75.55Not available in this settingRVU23C
2023-04-01$75.55Not available in this settingRVU23B
2023-01-01$75.55Not available in this settingRVU23A
2022-10-01$77.12Not available in this settingRVU22D
2022-07-01$77.12Not available in this settingRVU22C
2022-04-01$77.12Not available in this settingRVU22B
2022-01-01$77.12Not available in this settingRVU22A
2021-10-01$79.51Not available in this settingRVU21D
2021-07-01$79.51Not available in this settingRVU21C
2021-04-01$79.51Not available in this settingRVU21B
2021-01-01$79.51Not available in this settingRVU21A
2020-10-01$101.04Not available in this settingRVU20D
2020-07-01$101.04Not available in this settingRVU20C
2020-04-01$101.04Not available in this settingRVU20B
2020-01-01$101.04Not available in this settingRVU20A
2019-10-01$99.86Not available in this settingRVU19D
2019-07-01$99.86Not available in this settingRVU19C
2019-04-01$99.86Not available in this settingRVU19B
2019-01-01$99.86Not available in this settingRVU19A
2018-10-01$97.59Not available in this settingRVU18D
2018-07-01$97.59Not available in this settingRVU18C
2018-04-01$97.59Not available in this settingRVU18B
2018-01-01$97.59Not available in this settingRVU18AR1
2017-10-01$96.22Not available in this settingRVU17D
2017-07-01$96.22Not available in this settingRVU17C
2017-04-01$96.22Not available in this settingRVU17B
2017-01-01$96.22Not available in this settingRVU17A
2016-10-01$95.99Not available in this settingRVU16D
2016-07-01$95.99Not available in this settingRVU16C
2016-04-01$95.99Not available in this settingRVU16B
2016-01-01$95.99Not available in this settingRVU16A
2015-10-01$97.06Not available in this settingRVU15D
2015-07-01$97.06Not available in this settingRVU15C
2015-04-01$96.58Not available in this settingRVU15B
2015-01-01$96.58Not available in this settingRVU15A
2014-10-01$96.75Not available in this settingRVU14D
2014-07-01$96.75Not available in this settingRVU14C
2014-04-01$96.75Not available in this settingRVU14B
2014-01-01$96.75Not available in this settingRVU14A
2013-10-01$99.36Not available in this settingRVU13D
2013-07-01$99.36Not available in this settingRVU13C
2013-04-01$99.36Not available in this settingRVU13B
2013-01-01$99.36Not available in this settingRVU13AR

Price 76513 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

76513 billing questions

When should this code be chosen instead of 76512?

Use 76513 for diagnostic ultrasound imaging of the anterior segment. Code 76512 describes B-scan imaging used to evaluate the eye’s posterior segment.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Without either modifier, the claim represents the global service.

How is a bilateral study handled?

Document which eye or eyes were examined. CMS pays each side separately at 100% when the study is performed bilaterally.

Does the multiple-procedure reduction affect both components?

The ophthalmology diagnostic multiple-procedure reduction applies to the technical component of this service.

What documentation supports reporting 76513?

Record the clinical indication, laterality, anterior-segment images or findings, and the interpreting physician’s report. The record should support that the study evaluated the anterior segment.

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

Show the CMS file lines behind this rate
RVUs for 76513PPRRVU2026_Oct_nonQPP.csv, line 8,715 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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