Billing code 76519: Ocular biometryMedicare rate & RVUs in Ohio

Reports ultrasound measurement of the eye with intraocular lens power calculation, typically for selecting an implant before cataract surgery.

CMS RVU26DEffective Oct 1, 20261 payment locality104.8K Medicare services in 2024

Medicare pays $65.03 for 76519 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$65.03Office (non-facility)
—Hospital or facility

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 76519 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 76519 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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.

76519 in Ohio

76519 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$65.03Unavailable

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

Swap in your local Medicare rate.

Work 0.53Practice expense 1.53Malpractice 0.02

2.0800 adjusted RVUs×$33.4009 conversion factor=$69.47

All indexes start 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

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

76519 without 26 · national office

$69.47

Ocular biometry

76519-26 · Professional component

$30.06

Pays only the interpretation and report.

When to use modifier 26

76519 compared with similar codes

Compare codes

76519 vs 76516 vs 92136 vs 76511: national Medicare rates

Swap in your local Medicare rate.

  • 76519
    Ocular biometry · 0.53 wRVU
    $69.47
  • 76516
    Eye biometry · 0.39 wRVU
    $47.76−$21.71
  • 92136
    Optical biometry · 0.53 wRVU
    $48.10−$21.37
  • 76511
    Ocular ultrasound · 0.62 wRVU
    $57.45−$12.02

How to choose

76516Eye biometry
Both involve ultrasound ocular biometry, but 76519 includes intraocular lens power calculation; 76516 does not.
92136Optical biometry
Both include intraocular lens power calculation. Choose 76519 for ultrasound biometry and 92136 for optical biometry.
76511Ocular ultrasound
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
RVUs for 76519PPRRVU2026_Oct_nonQPP.csv, line 8,724 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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