$61.94–$93.70
76516 represents ultrasound A-scan biometry without intraocular lens power calculation; 76519 includes the calculation.
On this page
CMS RVU26D · Effective 2026-10-01
76516 Eye biometry Medicare reimbursement rates
Ultrasound A-scan biometry measures ocular dimensions, commonly for cataract assessment when the eye’s axial length must be determined. Compare 76516 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 76516?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$42.64–$63.94
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $21.30 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 76516 pays more and less
109 payment localities
$42.64 to $63.94
Ophthalmology
About 76516: Ocular A-scan biometry
Ultrasound A-scan biometry measures ocular dimensions, commonly for cataract assessment when the eye’s axial length must be determined.
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.
CMS billing rules for 76516
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Ophthalmology diagnostic multiple procedure reduction applies to the technical component.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.39 · 27%
- Practice expense (office) RVU1.02 · 71%
- Malpractice RVU0.02 · 1%
2K
Medicare services in 2024 · #2461 by national volume
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.
76516 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$52.04–$75.36
76511 is quantitative A-scan for diagnostic evaluation. 76516 is the biometry service used to measure ocular dimensions.
$62.08–$91.07
76510 combines B-scan imaging and quantitative A-scan for diagnostic evaluation; 76516 is A-scan biometry.
$44.25–$63.62
76512 is B-scan imaging, while 76516 measures ocular dimensions using A-scan biometry.
See how rates vary across the country
76516 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $56.19 | 1 |
| AL | $43.21 | 1 |
| AR | $42.64 | 1 |
| AZ | $46.61 | 1 |
| CA | $50.95–$63.94 | 29 |
| CO | $49.95 | 1 |
| CT | $50.79 | 1 |
| DC | $54.61 | 1 |
| DE | $47.35 | 1 |
| FL | $46.60–$50.18 | 3 |
| GA | $44.21–$48.48 | 2 |
| GU | $52.15 | 1 |
| HI | $52.15 | 1 |
| IA | $44.46 | 1 |
| ID | $44.69 | 1 |
| IL | $45.18–$49.29 | 4 |
| IN | $44.93 | 1 |
| KS | $44.16 | 1 |
| KY | $43.92 | 1 |
| LA | $43.82–$45.84 | 2 |
| MA | $49.64–$54.83 | 2 |
| MD | $48.25–$54.61 | 3 |
| ME | $44.79–$47.21 | 2 |
| MI | $44.89–$47.03 | 2 |
| MN | $48.28 | 1 |
| MO | $43.04–$46.13 | 3 |
| MS | $42.85 | 1 |
| MT | $47.76 | 1 |
| NC | $45.24 | 1 |
| ND | $47.37 | 1 |
| NE | $44.72 | 1 |
| NH | $49.08 | 1 |
| NJ | $51.48–$54.08 | 2 |
| NM | $45.07 | 1 |
| NV | $47.69 | 1 |
| NY | $45.86–$55.61 | 5 |
| OH | $44.80 | 1 |
| OK | $43.97 | 1 |
| OR | $47.43–$51.58 | 2 |
| PA | $44.93–$49.52 | 2 |
| PR | $48.13 | 1 |
| RI | $49.06 | 1 |
| SC | $45.07 | 1 |
| SD | $47.32 | 1 |
| TN | $44.35 | 1 |
| TX | $44.65–$49.69 | 8 |
| UT | $45.65 | 1 |
| VA | $46.99–$54.61 | 2 |
| VI | $48.13 | 1 |
| VT | $47.09 | 1 |
| WA | $49.58–$56.03 | 2 |
| WI | $45.87 | 1 |
| WV | $43.59 | 1 |
| WY | $47.59 | 1 |
Compare 76516 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $43.21 | Facility Unavailable |
| Alaska* | Office $56.19 | Facility Unavailable |
| Arizona | Office $46.61 | Facility Unavailable |
| Arkansas | Office $42.64 | Facility Unavailable |
| Atlanta | Office $48.48 | Facility Unavailable |
| Austin | Office $49.69 | Facility Unavailable |
| Bakersfield | Office $51.02 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $50.62 | Facility Unavailable |
| Beaumont | Office $44.65 | Facility Unavailable |
| Brazoria | Office $47.41 | Facility Unavailable |
| Chicago | Office $48.89 | Facility Unavailable |
| Chico | Office $50.95 | Facility Unavailable |
| Colorado | Office $49.95 | Facility Unavailable |
| Connecticut | Office $50.79 | Facility Unavailable |
| Dallas | Office $47.65 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $54.61 | Facility Unavailable |
| Delaware | Office $47.35 | Facility Unavailable |
| Detroit | Office $47.03 | Facility Unavailable |
| East St. Louis | Office $45.72 | Facility Unavailable |
| El Centro | Office $50.95 | Facility Unavailable |
| Fort Lauderdale | Office $48.75 | Facility Unavailable |
| Fort Worth | Office $47.32 | Facility Unavailable |
| Fresno | Office $50.95 | Facility Unavailable |
| Galveston | Office $47.51 | Facility Unavailable |
| Hanford-Corcoran | Office $50.95 | Facility Unavailable |
| Hawaii, Guam | Office $52.15 | Facility Unavailable |
| Houston | Office $47.88 | Facility Unavailable |
| Idaho | Office $44.69 | Facility Unavailable |
| Indiana | Office $44.93 | Facility Unavailable |
| Iowa | Office $44.46 | Facility Unavailable |
| Kansas | Office $44.16 | Facility Unavailable |
| Kentucky | Office $43.92 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $54.31 | Facility Unavailable |
| Madera | Office $50.95 | Facility Unavailable |
| Manhattan | Office $54.51 | Facility Unavailable |
| Merced | Office $50.95 | Facility Unavailable |
| Metropolitan Boston | Office $54.83 | Facility Unavailable |
| Metropolitan Kansas City | Office $45.67 | Facility Unavailable |
| Metropolitan Philadelphia | Office $49.52 | Facility Unavailable |
| Metropolitan St. Louis | Office $46.13 | Facility Unavailable |
| Miami | Office $50.18 | Facility Unavailable |
| Minnesota | Office $48.28 | Facility Unavailable |
| Mississippi | Office $42.85 | Facility Unavailable |
| Modesto | Office $50.95 | Facility Unavailable |
| Montana** | Office $47.76 | Facility Unavailable |
| Napa | Office $59.09 | Facility Unavailable |
| Nebraska | Office $44.72 | Facility Unavailable |
| Nevada** | Office $47.69 | Facility Unavailable |
| New Hampshire | Office $49.08 | Facility Unavailable |
| New Mexico | Office $45.07 | Facility Unavailable |
| New Orleans | Office $45.84 | Facility Unavailable |
| North Carolina | Office $45.24 | Facility Unavailable |
| North Dakota** | Office $47.37 | Facility Unavailable |
| Northern Nj | Office $54.08 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $55.61 | Facility Unavailable |
| Ohio | Office $44.80 | Facility Unavailable |
| Oklahoma | Office $43.97 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $54.08 | Facility Unavailable |
| Portland | Office $51.58 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $51.73 | Facility Unavailable |
| Puerto Rico | Office $48.13 | Facility Unavailable |
| Queens | Office $55.09 | Facility Unavailable |
| Redding | Office $50.95 | Facility Unavailable |
| Rest Of California | Office $50.95 | Facility Unavailable |
| Rest Of Florida | Office $46.60 | Facility Unavailable |
| Rest Of Georgia | Office $44.21 | Facility Unavailable |
| Rest Of Illinois | Office $45.18 | Facility Unavailable |
| Rest Of Louisiana | Office $43.82 | Facility Unavailable |
| Rest Of Maine | Office $44.79 | Facility Unavailable |
| Rest Of Maryland | Office $48.25 | Facility Unavailable |
| Rest Of Massachusetts | Office $49.64 | Facility Unavailable |
| Rest Of Michigan | Office $44.89 | Facility Unavailable |
| Rest Of Missouri | Office $43.04 | Facility Unavailable |
| Rest Of New Jersey | Office $51.48 | Facility Unavailable |
| Rest Of New York | Office $45.86 | Facility Unavailable |
| Rest Of Oregon | Office $47.43 | Facility Unavailable |
| Rest Of Pennsylvania | Office $44.93 | Facility Unavailable |
| Rest Of Texas | Office $45.96 | Facility Unavailable |
| Rest Of Washington | Office $49.58 | Facility Unavailable |
| Rhode Island | Office $49.06 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $51.17 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $53.48 | Facility Unavailable |
| Salinas | Office $53.27 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $54.53 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $62.61 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $62.58 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $63.94 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $63.85 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $52.41 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $55.05 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $53.47 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $55.61 | Facility Unavailable |
| Seattle (King Cnty) | Office $56.03 | Facility Unavailable |
| South Carolina | Office $45.07 | Facility Unavailable |
| South Dakota** | Office $47.32 | Facility Unavailable |
| Southern Maine | Office $47.21 | Facility Unavailable |
| Stockton | Office $50.95 | Facility Unavailable |
| Suburban Chicago | Office $49.29 | Facility Unavailable |
| Tennessee | Office $44.35 | Facility Unavailable |
| Utah | Office $45.65 | Facility Unavailable |
| Vallejo | Office $59.06 | Facility Unavailable |
| Vermont | Office $47.09 | Facility Unavailable |
| Virgin Islands | Office $48.13 | Facility Unavailable |
| Virginia | Office $46.99 | Facility Unavailable |
| Visalia | Office $50.95 | Facility Unavailable |
| West Virginia | Office $43.59 | Facility Unavailable |
| Wisconsin | Office $45.87 | Facility Unavailable |
| Wyoming** | Office $47.59 | Facility Unavailable |
| Yuba City | Office $50.95 | Facility Unavailable |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,71876514,,Echo exam of eye thickness,A,,0.14,0.19,,0.19,NA,0.02,0.35,0.35,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.89,0.89,0.08
8,71976514,26,Echo exam of eye thickness,A,,0.14,0.08,,0.08,,0.01,0.23,0.23,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,72076514,TC,Echo exam of eye thickness,A,,0.00,0.11,,0.11,NA,0.01,0.12,0.12,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,0.81,0.81,0.07
8,72176516,,Echo exam of eye,A,,0.39,1.02,,1.02,NA,0.02,1.43,1.43,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,3.43,3.43,0.05
8,72276516,26,Echo exam of eye,A,,0.39,0.27,,0.27,,0.01,0.67,0.67,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,72376516,TC,Echo exam of eye,A,,0.00,0.75,,0.75,NA,0.01,0.76,0.76,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,3.16,3.16,0.04
8,72476519,,Echo exam of eye,A,,0.53,1.53,,1.53,NA,0.02,2.08,2.08,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,09,0,99,3.53,3.53,0.04