CPT code 76516: Eye biometry, ultrasound A-scan2026 Medicare rate & RVUs

Medicare pays $47.76 for 76516 nationally in the office. Local office rates run $42.64–$63.94.

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

What 76516 covers

This service uses ultrasound A-scan measurements to determine ocular dimensions, including axial length. Ophthalmologists use the measurements in evaluating eyes, often when assessing a patient for cataract surgery and optical measurements are unavailable or unreliable. Ophthalmic staff may obtain the technical measurements, with a physician providing the interpretation. The service is commonly furnished in an ophthalmology office or an outpatient setting.

Choose this code for ultrasound biometry without intraocular lens power calculation; use the code-specific distinction from 76519 when that calculation is performed. Documentation should identify the eye measurements obtained and support the clinical reason for the study. The code is priced as bilateral, so modifier 50 does not increase payment. Bill globally without a modifier, or separate the interpretation with modifier 26 and the equipment and staff service with modifier TC. The ophthalmology diagnostic 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.

Where 76516 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

76516 rates by state

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

How the 76516 rate is calculated

Each of 76516’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.

Payment rules and modifiers for 76516

The CMS indicators that decide how 76516 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76516 compared with similar codes

How to choose

76519Ocular biometryUltrasound with lens calculation

76516 represents ultrasound A-scan biometry without intraocular lens power calculation; 76519 includes the calculation.

76511Ocular ultrasoundQuantitative A-scan only

76511 is quantitative A-scan for diagnostic evaluation. 76516 is the biometry service used to measure ocular dimensions.

76510Eye ultrasoundB-scan and quantitative A-scan

76510 combines B-scan imaging and quantitative A-scan for diagnostic evaluation; 76516 is A-scan biometry.

76512Eye ultrasoundDiagnostic B-scan

76512 is B-scan imaging, while 76516 measures ocular dimensions using A-scan biometry.

Codes related to 76516

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates