CPT code 76519: Ocular biometry, ultrasound with lens calculation2026 Medicare rate & RVUs in Oregon
Reports ultrasound measurement of the eye with intraocular lens power calculation, typically for selecting an implant before cataract surgery.
Medicare pays $69.07–$75.26 for 76519 in the office in Oregon, from Rest of Oregon to Portland, OR. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 76519 covers
An ophthalmologist uses an ultrasound A-scan to measure ocular dimensions, including axial length, and calculate the power of an intraocular lens for cataract surgery planning. The service is commonly performed in an ophthalmology office when ultrasound biometry is needed, including when optical measurement is not suitable. Clinical staff may obtain the measurements; the physician’s interpretation and lens calculation support the diagnostic service.
Report 76519 when the ultrasound biometry includes intraocular lens power calculation. The record should support the measurements, the resulting calculation, and the clinical purpose, such as cataract implant planning. Bill the global service without a component modifier, or report modifier 26 for interpretation or TC for the technical service when those portions are billed separately. The ophthalmology diagnostic multiple procedure reduction applies to the technical component. The code is priced as bilateral, so modifier 50 does not increase payment.
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 76519 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | $75.26 | Unavailable |
| Rest of Oregon | $69.07 | Unavailable |
How the 76519 rate is calculated
Each of 76519’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 · 76519
RVUs × geographic indexes × conversion factor
Work0.53
0.53 RVUs× 1.000 GPCI
Practice expense1.53
1.53 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
2.0800
Conversion factor
$33.4009
Medicare rate
$69.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76519
The CMS indicators that decide how 76519 is paid alongside other services.
CMS payment indicators · 76519
Ocular biometry, ultrasound with lens calculation
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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
76519 without 26 · national office
$69.47
Ocular biometry, ultrasound with lens calculation
76519-26 · Professional component
$30.06
Pays only the interpretation and report.
76519 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76516Eye biometryUltrasound A-scan
- Both involve ultrasound ocular biometry, but 76519 includes intraocular lens power calculation; 76516 does not.
- 92136Optical biometryWith IOL power calculation
- Both include intraocular lens power calculation. Choose 76519 for ultrasound biometry and 92136 for optical biometry.
- 76511Ocular ultrasoundQuantitative A-scan only
- 76511 reports quantitative A-scan ultrasound only. Use 76519 when the ultrasound biometry also includes the intraocular lens power calculation.
76519 billing questions
When should 76519 be chosen instead of 76516?
Use 76519 when ultrasound biometry includes an intraocular lens power calculation. Use 76516 for ultrasound biometry without that calculation.
Does 76519 include the lens power calculation?
Yes. The calculation is part of the service represented by 76519; do not report it as a separate service under 76516 for the same work.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the interpretation or TC for the equipment and staff portion when billing only that component. Without either modifier, the claim represents the global service.
Should modifier 50 be added for measurements of both eyes?
No. CMS prices 76519 as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting 76519?
Document the ultrasound measurements, the intraocular lens power calculation, and the reason for the service, such as planning an implant for cataract surgery.
Which portion is subject to the ophthalmology multiple procedure reduction?
The reduction applies to the technical component of 76519.
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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