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CMS RVU26D · Effective 2026-10-01

76516 in Austin

Office / nonfacility

$49.69

Base rate per service

Facility setting

Not available in this setting

Base rate per service

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.

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 rates for Austin, from the same CMS release.

76519

Ocular biometry

Ultrasound with lens calculation

$72.40

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

76511

Ocular ultrasound

Quantitative A-scan only

$59.51

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

76510

Eye ultrasound

B-scan and quantitative A-scan

$71.41

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

76512

Eye ultrasound

Diagnostic B-scan

$50.45

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

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 76516 is $44.65—$5.04 lower than the $49.69 rate in Austin. Both use the same code, release and participation basis.

76516 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $49.69

  2. Beaumont

    $44.65

    $5.04 lower than Austin

  3. Brazoria

    $47.41

    $2.28 lower than Austin

  4. Dallas

    $47.65

    $2.04 lower than Austin

  5. Fort Worth

    $47.32

    $2.37 lower than Austin

  6. Galveston

    $47.51

    $2.18 lower than Austin

  7. Houston

    $47.88

    $1.81 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 76516 ranges from $42.64 in Arkansas to $63.94 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 76516

    Office

    $45.96

    Facility

    Unavailable

    $3.73 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 76516

    Office

    $54.31

    Facility

    Unavailable

    $4.62 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 76516

    Office

    $54.61

    Facility

    Unavailable

    $4.92 higher than Austin for the office setting.

  • Miami

    Florida · 76516

    Office

    $50.18

    Facility

    Unavailable

    $0.49 higher than Austin for the office setting.

  • Chicago

    Illinois · 76516

    Office

    $48.89

    Facility

    Unavailable

    $0.80 lower than Austin for the office setting.

  • Manhattan

    New York · 76516

    Office

    $54.51

    Facility

    Unavailable

    $4.82 higher than Austin for the office setting.

  • Alaska*

    Alaska · 76516

    Office

    $56.19

    Facility

    Unavailable

    $6.50 higher than Austin for the office setting.

  • Alabama

    Alabama · 76516

    Office

    $43.21

    Facility

    Unavailable

    $6.48 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 76516

    Office

    $42.64

    Facility

    Unavailable

    $7.05 lower than Austin for the office setting.

  • Arizona

    Arizona · 76516

    Office

    $46.61

    Facility

    Unavailable

    $3.08 lower than Austin for the office setting.

  • Bakersfield

    California · 76516

    Office

    $51.02

    Facility

    Unavailable

    $1.33 higher than Austin for the office setting.

  • Chico

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • El Centro

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Fresno

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Madera

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Merced

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Modesto

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Napa

    California · 76516

    Office

    $59.09

    Facility

    Unavailable

    $9.40 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 76516

    Office

    $54.08

    Facility

    Unavailable

    $4.39 higher than Austin for the office setting.

  • Redding

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Rest Of California

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 76516

    Office

    $51.17

    Facility

    Unavailable

    $1.48 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 76516

    Office

    $53.48

    Facility

    Unavailable

    $3.79 higher than Austin for the office setting.

  • Salinas

    California · 76516

    Office

    $53.27

    Facility

    Unavailable

    $3.58 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 76516

    Office

    $54.53

    Facility

    Unavailable

    $4.84 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 76516

    Office

    $62.61

    Facility

    Unavailable

    $12.92 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 76516

    Office

    $62.58

    Facility

    Unavailable

    $12.89 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 76516

    Office

    $63.94

    Facility

    Unavailable

    $14.25 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 76516

    Office

    $63.85

    Facility

    Unavailable

    $14.16 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 76516

    Office

    $52.41

    Facility

    Unavailable

    $2.72 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 76516

    Office

    $55.05

    Facility

    Unavailable

    $5.36 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 76516

    Office

    $53.47

    Facility

    Unavailable

    $3.78 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 76516

    Office

    $55.61

    Facility

    Unavailable

    $5.92 higher than Austin for the office setting.

  • Stockton

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Vallejo

    California · 76516

    Office

    $59.06

    Facility

    Unavailable

    $9.37 higher than Austin for the office setting.

  • Visalia

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Yuba City

    California · 76516

    Office

    $50.95

    Facility

    Unavailable

    $1.26 higher than Austin for the office setting.

  • Colorado

    Colorado · 76516

    Office

    $49.95

    Facility

    Unavailable

    $0.26 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 76516

    Office

    $50.79

    Facility

    Unavailable

    $1.10 higher than Austin for the office setting.

  • Delaware

    Delaware · 76516

    Office

    $47.35

    Facility

    Unavailable

    $2.34 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 76516

    Office

    $48.75

    Facility

    Unavailable

    $0.94 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 76516

    Office

    $46.60

    Facility

    Unavailable

    $3.09 lower than Austin for the office setting.

  • Atlanta

    Georgia · 76516

    Office

    $48.48

    Facility

    Unavailable

    $1.21 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 76516

    Office

    $44.21

    Facility

    Unavailable

    $5.48 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 76516

    Office

    $52.15

    Facility

    Unavailable

    $2.46 higher than Austin for the office setting.

  • Iowa

    Iowa · 76516

    Office

    $44.46

    Facility

    Unavailable

    $5.23 lower than Austin for the office setting.

  • Idaho

    Idaho · 76516

    Office

    $44.69

    Facility

    Unavailable

    $5.00 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 76516

    Office

    $45.72

    Facility

    Unavailable

    $3.97 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 76516

    Office

    $45.18

    Facility

    Unavailable

    $4.51 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 76516

    Office

    $49.29

    Facility

    Unavailable

    $0.40 lower than Austin for the office setting.

  • Indiana

    Indiana · 76516

    Office

    $44.93

    Facility

    Unavailable

    $4.76 lower than Austin for the office setting.

  • Kansas

    Kansas · 76516

    Office

    $44.16

    Facility

    Unavailable

    $5.53 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 76516

    Office

    $43.92

    Facility

    Unavailable

    $5.77 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 76516

    Office

    $45.84

    Facility

    Unavailable

    $3.85 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 76516

    Office

    $43.82

    Facility

    Unavailable

    $5.87 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 76516

    Office

    $54.83

    Facility

    Unavailable

    $5.14 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 76516

    Office

    $49.64

    Facility

    Unavailable

    $0.05 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 76516

    Office

    $50.62

    Facility

    Unavailable

    $0.93 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 76516

    Office

    $48.25

    Facility

    Unavailable

    $1.44 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 76516

    Office

    $44.79

    Facility

    Unavailable

    $4.90 lower than Austin for the office setting.

  • Southern Maine

    Maine · 76516

    Office

    $47.21

    Facility

    Unavailable

    $2.48 lower than Austin for the office setting.

  • Detroit

    Michigan · 76516

    Office

    $47.03

    Facility

    Unavailable

    $2.66 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 76516

    Office

    $44.89

    Facility

    Unavailable

    $4.80 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 76516

    Office

    $48.28

    Facility

    Unavailable

    $1.41 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 76516

    Office

    $45.67

    Facility

    Unavailable

    $4.02 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 76516

    Office

    $46.13

    Facility

    Unavailable

    $3.56 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 76516

    Office

    $43.04

    Facility

    Unavailable

    $6.65 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 76516

    Office

    $42.85

    Facility

    Unavailable

    $6.84 lower than Austin for the office setting.

  • Montana**

    Montana · 76516

    Office

    $47.76

    Facility

    Unavailable

    $1.93 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 76516

    Office

    $45.24

    Facility

    Unavailable

    $4.45 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 76516

    Office

    $47.37

    Facility

    Unavailable

    $2.32 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 76516

    Office

    $44.72

    Facility

    Unavailable

    $4.97 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 76516

    Office

    $49.08

    Facility

    Unavailable

    $0.61 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 76516

    Office

    $54.08

    Facility

    Unavailable

    $4.39 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 76516

    Office

    $51.48

    Facility

    Unavailable

    $1.79 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 76516

    Office

    $45.07

    Facility

    Unavailable

    $4.62 lower than Austin for the office setting.

  • Nevada**

    Nevada · 76516

    Office

    $47.69

    Facility

    Unavailable

    $2.00 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 76516

    Office

    $55.61

    Facility

    Unavailable

    $5.92 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 76516

    Office

    $51.73

    Facility

    Unavailable

    $2.04 higher than Austin for the office setting.

  • Queens

    New York · 76516

    Office

    $55.09

    Facility

    Unavailable

    $5.40 higher than Austin for the office setting.

  • Rest Of New York

    New York · 76516

    Office

    $45.86

    Facility

    Unavailable

    $3.83 lower than Austin for the office setting.

  • Ohio

    Ohio · 76516

    Office

    $44.80

    Facility

    Unavailable

    $4.89 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 76516

    Office

    $43.97

    Facility

    Unavailable

    $5.72 lower than Austin for the office setting.

  • Portland

    Oregon · 76516

    Office

    $51.58

    Facility

    Unavailable

    $1.89 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 76516

    Office

    $47.43

    Facility

    Unavailable

    $2.26 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 76516

    Office

    $49.52

    Facility

    Unavailable

    $0.17 lower than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 76516

    Office

    $44.93

    Facility

    Unavailable

    $4.76 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 76516

    Office

    $48.13

    Facility

    Unavailable

    $1.56 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 76516

    Office

    $49.06

    Facility

    Unavailable

    $0.63 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 76516

    Office

    $45.07

    Facility

    Unavailable

    $4.62 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 76516

    Office

    $47.32

    Facility

    Unavailable

    $2.37 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 76516

    Office

    $44.35

    Facility

    Unavailable

    $5.34 lower than Austin for the office setting.

  • Utah

    Utah · 76516

    Office

    $45.65

    Facility

    Unavailable

    $4.04 lower than Austin for the office setting.

  • Virginia

    Virginia · 76516

    Office

    $46.99

    Facility

    Unavailable

    $2.70 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 76516

    Office

    $48.13

    Facility

    Unavailable

    $1.56 lower than Austin for the office setting.

  • Vermont

    Vermont · 76516

    Office

    $47.09

    Facility

    Unavailable

    $2.60 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 76516

    Office

    $49.58

    Facility

    Unavailable

    $0.11 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 76516

    Office

    $56.03

    Facility

    Unavailable

    $6.34 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 76516

    Office

    $45.87

    Facility

    Unavailable

    $3.82 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 76516

    Office

    $43.59

    Facility

    Unavailable

    $6.10 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 76516

    Office

    $47.59

    Facility

    Unavailable

    $2.10 lower than Austin for the office setting.

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.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 / territoryRate 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

Explore 76516 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 76516 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$54.66

$49.69 × 110% = $54.66

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 76516 in Austin.

PPRRVU2026_Oct_nonQPP.csv

8,721

Code
76516
Physician work
0.39
Practice expense
1.02
Malpractice
0.02

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 76516 in Austin
ComponentRVULocality factorAdjusted
Physician work0.39× 1.0020.3908
Practice expense1.02× 1.0581.0792
Malpractice0.02× 0.8860.0177
Total RVUs1.4877
Conversion factor× 33.4009

Office / nonfacility rate, Austin$49.69

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 76516 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.391.002
Practice expense1.021.058
Malpractice0.020.886

(0.39 × 1.002 + 1.02 × 1.058 + 0.02 × 0.886) × $33.4009 = $49.69

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

76516 · Office / nonfacility

$49.69

Effective 2026-10-01

The base rate is $3.00 higher than on 2025-10-01, moving from $46.69 to $49.69 (6.4%).

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

    $46.69changed to$49.69

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $46.69

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$49.69Not available in this settingRVU26D
2026-07-01$49.69Not available in this settingRVU26C
2026-04-01$49.69Not available in this settingRVU26B
2026-01-01$49.69Not available in this settingRVU26A
2025-10-01$46.69Not available in this settingRVU25D
2025-07-01$46.69Not available in this settingRVU25C
2025-04-01$46.69Not available in this settingRVU25B
2025-01-01$46.69Not available in this settingRVU25A

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.

RVUs for 76516PPRRVU2026_Oct_nonQPP.csv, line 8,721 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet