CPT code 76516: Eye biometry2026 Medicare rate & RVUs in Oklahoma
Ultrasound A-scan biometry measures ocular dimensions, commonly for cataract assessment when the eye’s axial length must be determined.
Medicare pays $43.97 for 76516 in the office in Oklahoma (Oklahoma). 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.
On this page 9 sections
What 76516 covers
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.
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 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $43.97 | Unavailable |
How the 76516 rate is calculated
Each of 76516’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 · 76516
RVUs × geographic indexes × conversion factor
Work0.39
0.39 RVUs× 1.000 GPCI
Practice expense1.02
1.02 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.4300
Conversion factor
$33.4009
Medicare rate
$47.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76516
The CMS indicators that decide how 76516 is paid alongside other services.
CMS payment indicators · 76516
Eye biometry
| 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
76516 without 26 · national office
$47.76
Eye biometry
76516-26 · Professional component
$22.38
Pays only the interpretation and report.
76516 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 76519Ocular biometry
- 76516 represents ultrasound A-scan biometry without intraocular lens power calculation; 76519 includes the calculation.
- 76511Ocular ultrasound
- 76511 is quantitative A-scan for diagnostic evaluation. 76516 is the biometry service used to measure ocular dimensions.
- 76510Eye ultrasound
- 76510 combines B-scan imaging and quantitative A-scan for diagnostic evaluation; 76516 is A-scan biometry.
- 76512Eye ultrasound
- 76512 is B-scan imaging, while 76516 measures ocular dimensions using A-scan biometry.
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 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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