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

Ultrasound A-scan biometry measures ocular dimensions, commonly for cataract assessment when the eye’s axial length must be determined.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Virginia, Medicare pays $46.99 for 76516 in the office.

$46.99Office (non-facility)
Not available in this settingHospital or facility
−1.6%vs the national office rate ($47.76)

Check a contract rate as a % of Medicare · 76516 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 76516 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 76516 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 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.

How Virginia compares for 76516

Across 109 of 109 payment localities, the office rate for 76516 runs from $42.64 in Arkansas to $63.94 in San Benito County, CA. Virginia pays $46.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

76516 in Virginia vs other payment areas
  1. Virginia · this page$46.99
  2. Los Angeles, CA · California$54.31+$7.32
  3. Washington, DC area · District of Columbia$54.61+$7.62
  4. Miami, FL · Florida$50.18+$3.19
  5. Chicago, IL · Illinois$48.89+$1.90
  6. Manhattan, NY · New York$54.51+$7.52
  7. Alaska · Alaska$56.19+$9.20

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

Every other payment area

76516 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$43.21—
ArkansasArkansas$42.64—
ArizonaArizona$46.61—
Bakersfield, CACalifornia$51.02—
Chico, CACalifornia$50.95—
El Centro, CACalifornia$50.95—
Fresno, CACalifornia$50.95—
Hanford, CACalifornia$50.95—

76516 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.

$42.64

$57.45

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

View every state and territory as a table
76516 office rate range by state
State / territoryOffice rate rangeLocalities
AK$56.191
AL$43.211
AR$42.641
AZ$46.611
CA$50.95–$63.9429
CO$49.951
CT$50.791
DC$54.611
DE$47.351
FL$46.60–$50.183
GA$44.21–$48.482
GU$52.151
HI$52.151
IA$44.461
ID$44.691
IL$45.18–$49.294
IN$44.931
KS$44.161
KY$43.921
LA$43.82–$45.842
MA$49.64–$54.832
MD$48.25–$54.613
ME$44.79–$47.212
MI$44.89–$47.032
MN$48.281
MO$43.04–$46.133
MS$42.851
MT$47.761
NC$45.241
ND$47.371
NE$44.721
NH$49.081
NJ$51.48–$54.082
NM$45.071
NV$47.691
NY$45.86–$55.615
OH$44.801
OK$43.971
OR$47.43–$51.582
PA$44.93–$49.522
PR$48.131
RI$49.061
SC$45.071
SD$47.321
TN$44.351
TX$44.65–$49.698
UT$45.651
VA$46.99–$54.612
VI$48.131
VT$47.091
WA$49.58–$56.032
WI$45.871
WV$43.591
WY$47.591

See 76516 in every payment locality

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.

How the rate is built · 76516

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.39

0.39 RVUs× 1.000 GPCI

Practice expense1.02

1.02 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.4300

Conversion factor

$33.4009

Medicare rate

$47.76

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,721

Code
76516
Physician work
0.39
Practice expense
1.02
Malpractice
0.02

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 76516 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.39× 1.0000.3900
Practice expense1.02× 0.9831.0027
Malpractice0.02× 0.7060.0141
Total RVUs1.4068
Conversion factor× 33.4009

Office rate, Virginia$46.99

Office: (0.39 × 1 + 1.02 × 0.983 + 0.02 × 0.706) × $33.4009 = $46.99

Open 76516 in the RVU calculator

Payment rules and modifiers for 76516

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

CMS payment indicators · 76516

Eye biometry, ultrasound A-scan

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures7Diagnostic ophthalmology reduction applies to the technical component.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
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

76516 without 26 · national office

$47.76

Eye biometry, ultrasound A-scan

76516-26 · Professional component

$22.38

Pays only the interpretation and report.

When to use modifier 26

How 76516 has changed in Virginia

76516 · Office / nonfacility

$46.99

Effective 2026-10-01

The base rate is $2.34 higher than on 2025-10-01, moving from $44.65 to $46.99 (5.2%).

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

    $44.65changed to$46.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.40 changed to 0.39
    • Practice expense RVU 0.98 changed to 1.02
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $45.94changed to$44.65

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $45.19changed to$45.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $46.66changed to$45.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.97 changed to 0.98
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755
  5. January 1, 2023

    RVU23A

    $47.17changed to$46.66

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.95 changed to 0.97
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $47.22changed to$47.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.94 changed to 0.95

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $48.71changed to$47.22

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $54.51changed to$48.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.11 changed to 0.94
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $64.04changed to$54.51

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.38 changed to 1.11

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $78.68changed to$64.04

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 0.54 changed to 0.40
    • Practice expense RVU 1.66 changed to 1.38
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $78.35changed to$78.68

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $78.63changed to$78.35

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $78.24changed to$78.63

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $77.83changed to$78.24

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.65 changed to 1.66
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $79.37changed to$77.83

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.82 changed to 1.65
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $79.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$46.99Not available in this settingRVU26D
2026-07-01$46.99Not available in this settingRVU26C
2026-04-01$46.99Not available in this settingRVU26B
2026-01-01$46.99Not available in this settingRVU26A
2025-10-01$44.65Not available in this settingRVU25D
2025-07-01$44.65Not available in this settingRVU25C
2025-04-01$44.65Not available in this settingRVU25B
2025-01-01$44.65Not available in this settingRVU25A
2024-10-01$45.94Not available in this settingRVU24D
2024-07-01$45.94Not available in this settingRVU24C
2024-04-01$45.94Not available in this settingRVU24B
2024-03-09$45.94Not available in this settingRVU24AR
2024-01-01$45.19Not available in this settingRVU24A
2023-10-01$46.66Not available in this settingRVU23D
2023-07-01$46.66Not available in this settingRVU23C
2023-04-01$46.66Not available in this settingRVU23B
2023-01-01$46.66Not available in this settingRVU23A
2022-10-01$47.17Not available in this settingRVU22D
2022-07-01$47.17Not available in this settingRVU22C
2022-04-01$47.17Not available in this settingRVU22B
2022-01-01$47.17Not available in this settingRVU22A
2021-10-01$47.22Not available in this settingRVU21D
2021-07-01$47.22Not available in this settingRVU21C
2021-04-01$47.22Not available in this settingRVU21B
2021-01-01$47.22Not available in this settingRVU21A
2020-10-01$48.71Not available in this settingRVU20D
2020-07-01$48.71Not available in this settingRVU20C
2020-04-01$48.71Not available in this settingRVU20B
2020-01-01$48.71Not available in this settingRVU20A
2019-10-01$54.51Not available in this settingRVU19D
2019-07-01$54.51Not available in this settingRVU19C
2019-04-01$54.51Not available in this settingRVU19B
2019-01-01$54.51Not available in this settingRVU19A
2018-10-01$64.04Not available in this settingRVU18D
2018-07-01$64.04Not available in this settingRVU18C
2018-04-01$64.04Not available in this settingRVU18B
2018-01-01$64.04Not available in this settingRVU18AR1
2017-10-01$78.68Not available in this settingRVU17D
2017-07-01$78.68Not available in this settingRVU17C
2017-04-01$78.68Not available in this settingRVU17B
2017-01-01$78.68Not available in this settingRVU17A
2016-10-01$78.35Not available in this settingRVU16D
2016-07-01$78.35Not available in this settingRVU16C
2016-04-01$78.35Not available in this settingRVU16B
2016-01-01$78.35Not available in this settingRVU16A
2015-10-01$78.63Not available in this settingRVU15D
2015-07-01$78.63Not available in this settingRVU15C
2015-04-01$78.24Not available in this settingRVU15B
2015-01-01$78.24Not available in this settingRVU15A
2014-10-01$77.83Not available in this settingRVU14D
2014-07-01$77.83Not available in this settingRVU14C
2014-04-01$77.83Not available in this settingRVU14B
2014-01-01$77.83Not available in this settingRVU14A
2013-10-01$79.37Not available in this settingRVU13D
2013-07-01$79.37Not available in this settingRVU13C
2013-04-01$79.37Not available in this settingRVU13B
2013-01-01$79.37Not available in this settingRVU13AR

Price 76516 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

76516 billing questions

When should 76516 be used instead of 76519?

Use 76516 for ultrasound A-scan biometry without an intraocular lens power calculation. When the study includes that calculation, 76519 is the relevant code.

Can the professional and technical services be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

Should modifier 50 be added when both eyes are examined?

No. CMS prices 76516 as bilateral, and modifier 50 does not increase payment.

What does the multiple-procedure reduction affect?

The ophthalmology diagnostic multiple-procedure reduction applies to the technical component of 76516.

What documentation supports reporting 76516?

Document the clinical reason for ultrasound biometry, the ocular measurements obtained, and the interpretation. The record should make clear whether intraocular lens power calculation was part of the service.

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 76516PPRRVU2026_Oct_nonQPP.csv, line 8,721 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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