$50.79
Both involve ultrasound ocular biometry, but 76519 includes intraocular lens power calculation; 76516 does not.
On this page
CMS RVU26D · Effective 2026-10-01
76519 Ocular biometry Medicare reimbursement rates in Connecticut
Reports ultrasound measurement of the eye with intraocular lens power calculation, typically for selecting an implant before cataract surgery. Compare 76519 office and facility rates across CMS payment localities in Connecticut.
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 76519 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$73.90
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
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.
Ophthalmology
About 76519: Ultrasound ocular biometry with lens calculation
Reports ultrasound measurement of the eye with intraocular lens power calculation, typically for selecting an implant before cataract surgery.
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.
CMS billing rules for 76519
- 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 RVU0.53 · 25%
- Practice expense (office) RVU1.53 · 74%
- Malpractice RVU0.02 · 1%
104.8K
Medicare services in 2024 · #542 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.
76519 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$50.88
Both include intraocular lens power calculation. Choose 76519 for ultrasound biometry and 92136 for optical biometry.
$60.78
76511 reports quantitative A-scan ultrasound only. Use 76519 when the ultrasound biometry also includes the intraocular lens power calculation.
Compare 76519 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.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$73.90
Facility
Unavailable
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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 76519 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,724
- Code
- 76519
- Physician work
- 0.53
- Practice expense
- 1.53
- Malpractice
- 0.02
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.53 | × 1.020 | 0.5406 |
| Practice expense | 1.53 | × 1.077 | 1.6478 |
| Malpractice | 0.02 | × 1.210 | 0.0242 |
| Total RVUs | 2.2126 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$73.90
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.53 | 1.02 |
| Practice expense | 1.53 | 1.077 |
| Malpractice | 0.02 | 1.21 |
(0.53 × 1.02 + 1.53 × 1.077 + 0.02 × 1.21) × $33.4009 = $73.90
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.
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 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.
8,72176516,,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
8,72576519,26,Echo exam of eye,A,,0.53,0.36,,0.36,,0.01,0.90,0.90,1,XXX,0.00,0.00,0.00,7,3,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,72676519,TC,Echo exam of eye,A,,0.00,1.17,,1.17,NA,0.01,1.18,1.18,1,XXX,0.00,0.00,0.00,7,2,0,0,0,9,,33.4009,01,0,99,3.17,3.17,0.03
8,72776529,,Echo exam of eye,A,,0.56,2.02,,2.02,NA,0.03,2.61,2.61,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,3.03,3.03,0.04
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808