CPT code 76513: Eye ultrasound, anterior segment2026 Medicare rate & RVUs in Tennessee
Reports diagnostic ultrasound of the eye’s anterior segment, often used to assess structures such as the iris, angle, or ciliary body.
In Tennessee, Medicare pays $71.07 for 76513 in the office.
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.
On this page 11 sections
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 Tennessee 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. Tennessee pays $71.07. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Tennessee · this page$71.07
- Los Angeles, CA · California$87.34+$16.27
- Washington, DC area · District of Columbia$87.62+$16.55
- Miami, FL · Florida$79.81+$8.74
- Chicago, IL · Illinois$77.77+$6.70
- Manhattan, NY · New York$87.23+$16.16
- Alaska · Alaska$89.69+$18.62
Other areas in Tennessee first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $81.90 | — |
| Merced, CACalifornia | $81.90 | — |
| Modesto, CACalifornia | $81.90 | — |
| Napa, CACalifornia | $95.25 | — |
| Oxnard, CACalifornia | $87.00 | — |
| Redding, CACalifornia | $81.90 | — |
| Rest of CaliforniaCalifornia | $81.90 | — |
| Riverside, CACalifornia | $82.13 | — |
| Sacramento, CACalifornia | $86.03 | — |
| Salinas, CACalifornia | $85.71 | — |
| San Diego, CACalifornia | $87.77 | — |
| Marin County, CACalifornia | $101.01 | — |
| San Francisco, CACalifornia | $100.98 | — |
| San Benito County, CACalifornia | $103.15 | — |
| Santa Clara County, CACalifornia | $103.06 | — |
| San Luis Obispo, CACalifornia | $84.31 | — |
| Santa Cruz, CACalifornia | $88.66 | — |
| Santa Maria, CACalifornia | $86.04 | — |
| Santa Rosa, CACalifornia | $89.56 | — |
| Stockton, CACalifornia | $81.90 | — |
| Vallejo, CACalifornia | $95.21 | — |
| Visalia, CACalifornia | $81.90 | — |
| Yuba City, CACalifornia | $81.90 | — |
| ColoradoColorado | $80.17 | — |
| ConnecticutConnecticut | $81.34 | — |
| DelawareDelaware | $75.85 | — |
| Fort Lauderdale, FLFlorida | $77.76 | — |
| Rest of FloridaFlorida | $74.36 | — |
| Atlanta, GAGeorgia | $77.58 | — |
| Rest of GeorgiaGeorgia | $70.56 | — |
| Hawaii, Guam, HIHawaii | $83.89 | — |
| IowaIowa | $71.32 | — |
| IdahoIdaho | $71.65 | — |
| East St. Louis, ILIllinois | $72.68 | — |
| Rest of IllinoisIllinois | $71.98 | — |
| Suburban Chicago, ILIllinois | $78.66 | — |
| IndianaIndiana | $72.05 | — |
| KansasKansas | $70.77 | — |
| KentuckyKentucky | $70.20 | — |
| New Orleans, LALouisiana | $73.27 | — |
| Rest of LouisianaLouisiana | $70.01 | — |
| Metropolitan Boston, MAMassachusetts | $88.11 | — |
| Rest of MassachusettsMassachusetts | $79.64 | — |
| Baltimore area, MDMaryland | $81.06 | — |
| Rest of MarylandMaryland | $77.30 | — |
| Rest of MaineMaine | $71.75 | — |
| Southern Maine, MEMaine | $75.74 | — |
| Detroit, MIMichigan | $74.98 | — |
| Rest of MichiganMichigan | $71.69 | — |
| MinnesotaMinnesota | $77.65 | — |
| Metropolitan Kansas City, MOMissouri | $73.05 | — |
| Metropolitan St. Louis, MOMissouri | $73.80 | — |
| Rest of MissouriMissouri | $68.73 | — |
| MississippiMississippi | $68.51 | — |
| MontanaMontana | $76.49 | — |
| North CarolinaNorth Carolina | $72.49 | — |
| North DakotaNorth Dakota | $76.09 | — |
| NebraskaNebraska | $71.75 | — |
| New HampshireNew Hampshire | $78.71 | — |
| Northern New JerseyNew Jersey | $86.75 | — |
| Rest of New JerseyNew Jersey | $82.50 | — |
| New MexicoNew Mexico | $71.96 | — |
| NevadaNevada | $76.43 | — |
| NYC suburbs and Long Island, NYNew York | $88.93 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $82.85 | — |
| Queens, NYNew York | $88.26 | — |
| Rest of New YorkNew York | $73.48 | — |
| OhioOhio | $71.61 | — |
| OklahomaOklahoma | $70.33 | — |
| Portland, OROregon | $82.86 | — |
| Rest of OregonOregon | $76.07 | — |
| Metropolitan Philadelphia, PAPennsylvania | $79.27 | — |
| Rest of PennsylvaniaPennsylvania | $71.85 | — |
| Puerto RicoPuerto Rico | $77.10 | — |
| Rhode IslandRhode Island | $78.64 | — |
| South CarolinaSouth Carolina | $72.12 | — |
| South DakotaSouth Dakota | $76.04 | — |
| Austin, TXTexas | $79.71 | — |
| Beaumont, TXTexas | $71.39 | — |
| Brazoria, TXTexas | $75.99 | — |
| Dallas, TXTexas | $76.35 | — |
| Fort Worth, TXTexas | $75.79 | — |
| Galveston, TXTexas | $76.14 | — |
| Houston, TXTexas | $76.50 | — |
| Rest of TexasTexas | $73.56 | — |
| UtahUtah | $73.05 | — |
| VirginiaVirginia | $75.34 | — |
| Virgin Islands, VIUnited States Virgin Islands | $77.10 | — |
| VermontVermont | $75.60 | — |
| Rest of WashingtonWashington | $79.56 | — |
| King County, WAWashington | $90.09 | — |
| WisconsinWisconsin | $73.67 | — |
| West VirginiaWest Virginia | $69.43 | — |
| WyomingWyoming | $76.31 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $89.69 | 1 |
| AL | $69.18 | 1 |
| AR | $68.25 | 1 |
| AZ | $74.65 | 1 |
| CA | $81.90–$103.15 | 29 |
| CO | $80.17 | 1 |
| CT | $81.34 | 1 |
| DC | $87.62 | 1 |
| DE | $75.85 | 1 |
| FL | $74.36–$79.81 | 3 |
| GA | $70.56–$77.58 | 2 |
| GU | $83.89 | 1 |
| HI | $83.89 | 1 |
| IA | $71.32 | 1 |
| ID | $71.65 | 1 |
| IL | $71.98–$78.66 | 4 |
| IN | $72.05 | 1 |
| KS | $70.77 | 1 |
| KY | $70.20 | 1 |
| LA | $70.01–$73.27 | 2 |
| MA | $79.64–$88.11 | 2 |
| MD | $77.30–$87.62 | 3 |
| ME | $71.75–$75.74 | 2 |
| MI | $71.69–$74.98 | 2 |
| MN | $77.65 | 1 |
| MO | $68.73–$73.80 | 3 |
| MS | $68.51 | 1 |
| MT | $76.49 | 1 |
| NC | $72.49 | 1 |
| ND | $76.09 | 1 |
| NE | $71.75 | 1 |
| NH | $78.71 | 1 |
| NJ | $82.50–$86.75 | 2 |
| NM | $71.96 | 1 |
| NV | $76.43 | 1 |
| NY | $73.48–$88.93 | 5 |
| OH | $71.61 | 1 |
| OK | $70.33 | 1 |
| OR | $76.07–$82.86 | 2 |
| PA | $71.85–$79.27 | 2 |
| PR | $77.10 | 1 |
| RI | $78.64 | 1 |
| SC | $72.12 | 1 |
| SD | $76.04 | 1 |
| TN | $71.07 | 1 |
| TX | $71.39–$79.71 | 8 |
| UT | $73.05 | 1 |
| VA | $75.34–$87.62 | 2 |
| VI | $77.10 | 1 |
| VT | $75.60 | 1 |
| WA | $79.56–$90.09 | 2 |
| WI | $73.67 | 1 |
| WV | $69.43 | 1 |
| WY | $76.31 | 1 |
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
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 Tennessee 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
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 1.68 | × 0.909 | 1.5271 |
| Malpractice | 0.02 | × 0.537 | 0.0107 |
| Total RVUs | 2.1279 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Tennessee$71.07
Office: (0.59 × 1 + 1.68 × 0.909 + 0.02 × 0.537) × $33.4009 = $71.07
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 7 | Diagnostic ophthalmology reduction applies to the technical component. |
| Bilateral (modifier 50) | 3 | Each side paid at 100% (no 150% cap). |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 76513 has changed in Tennessee
76513 · Office / nonfacility
$71.07
Effective 2026-10-01
The base rate is $4.65 higher than on 2025-10-01, moving from $66.42 to $71.07 (7.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$66.42changed to$71.07
- 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
- Practice expense GPCI 0.896 changed to 0.909
- Malpractice GPCI 0.544 changed to 0.537
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$68.95changed to$66.42
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.63 changed to 1.61
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$67.83changed to$68.95
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$69.76changed to$67.83
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.62 changed to 1.63
- Practice expense GPCI 0.894 changed to 0.896
- Malpractice GPCI 0.518 changed to 0.544
January 1, 2023
RVU23A
$71.11changed to$69.76
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.892 changed to 0.894
- Malpractice GPCI 0.492 changed to 0.518
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$73.26changed to$71.11
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.67 changed to 1.62
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$93.14changed to$73.26
- 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
- Practice expense GPCI 0.897 changed to 0.892
- Malpractice GPCI 0.509 changed to 0.492
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$92.35changed to$93.14
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.10 changed to 2.13
- Practice expense GPCI 0.901 changed to 0.897
- Malpractice GPCI 0.526 changed to 0.509
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$90.31changed to$92.35
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.04 changed to 2.10
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$90.31
Held through RVU18C, RVU18D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $71.07 | Not available in this setting | RVU26D |
| 2026-07-01 | $71.07 | Not available in this setting | RVU26C |
| 2026-04-01 | $71.07 | Not available in this setting | RVU26B |
| 2026-01-01 | $71.07 | Not available in this setting | RVU26A |
| 2025-10-01 | $66.42 | Not available in this setting | RVU25D |
| 2025-07-01 | $66.42 | Not available in this setting | RVU25C |
| 2025-04-01 | $66.42 | Not available in this setting | RVU25B |
| 2025-01-01 | $66.42 | Not available in this setting | RVU25A |
| 2024-10-01 | $68.95 | Not available in this setting | RVU24D |
| 2024-07-01 | $68.95 | Not available in this setting | RVU24C |
| 2024-04-01 | $68.95 | Not available in this setting | RVU24B |
| 2024-03-09 | $68.95 | Not available in this setting | RVU24AR |
| 2024-01-01 | $67.83 | Not available in this setting | RVU24A |
| 2023-10-01 | $69.76 | Not available in this setting | RVU23D |
| 2023-07-01 | $69.76 | Not available in this setting | RVU23C |
| 2023-04-01 | $69.76 | Not available in this setting | RVU23B |
| 2023-01-01 | $69.76 | Not available in this setting | RVU23A |
| 2022-10-01 | $71.11 | Not available in this setting | RVU22D |
| 2022-07-01 | $71.11 | Not available in this setting | RVU22C |
| 2022-04-01 | $71.11 | Not available in this setting | RVU22B |
| 2022-01-01 | $71.11 | Not available in this setting | RVU22A |
| 2021-10-01 | $73.26 | Not available in this setting | RVU21D |
| 2021-07-01 | $73.26 | Not available in this setting | RVU21C |
| 2021-04-01 | $73.26 | Not available in this setting | RVU21B |
| 2021-01-01 | $73.26 | Not available in this setting | RVU21A |
| 2020-10-01 | $93.14 | Not available in this setting | RVU20D |
| 2020-07-01 | $93.14 | Not available in this setting | RVU20C |
| 2020-04-01 | $93.14 | Not available in this setting | RVU20B |
| 2020-01-01 | $93.14 | Not available in this setting | RVU20A |
| 2019-10-01 | $92.35 | Not available in this setting | RVU19D |
| 2019-07-01 | $92.35 | Not available in this setting | RVU19C |
| 2019-04-01 | $92.35 | Not available in this setting | RVU19B |
| 2019-01-01 | $92.35 | Not available in this setting | RVU19A |
| 2018-10-01 | $90.31 | Not available in this setting | RVU18D |
| 2018-07-01 | $90.31 | Not available in this setting | RVU18C |
| 2018-04-01 | $90.31 | Not available in this setting | RVU18B |
| 2018-01-01 | Rate data unavailable | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Not available in this setting | RVU17D |
| 2017-07-01 | Rate data unavailable | Not available in this setting | RVU17C |
| 2017-04-01 | Rate data unavailable | Not available in this setting | RVU17B |
| 2017-01-01 | Rate data unavailable | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Tennessee rate applies
Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.
- Adams
- Adamsville
- Alamo
- Alcoa
- Alexandria
- Algood
- Allardt
- Altamont
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
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