Billing code 76512: Eye ultrasoundMedicare rate & RVUs in Oregon
Reports diagnostic B-scan ultrasound of the eye, commonly used to assess the posterior segment when direct visualization is limited by opaque media.
Medicare pays $48.45–$52.19 for 76512 in the office in Oregon, from Rest Of Oregon to Portland. 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 76512 covers
An ophthalmic B-scan uses ultrasound to create an image of the eye’s internal structures. Ophthalmologists use it to evaluate the posterior segment when the view through the pupil is obscured, such as by dense cataract or vitreous hemorrhage, and to investigate findings such as suspected retinal detachment or an intraocular mass. The scan may be performed in an ophthalmology office or facility, with image acquisition by qualified staff and interpretation by the responsible clinician.
Select this code for a diagnostic B-scan rather than a quantitative A-scan alone or a combined B-scan and quantitative A-scan service. Documentation should identify the eye, clinical indication, ultrasound findings, and interpretation. Medicare recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither for the global service. When multiple ophthalmology diagnostic procedures are performed, the reduction applies to the technical component. For bilateral services, each side is paid separately at 100%.
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.
Where 76512 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $52.19 | Unavailable |
| Rest Of Oregon | $48.45 | Unavailable |
How the 76512 rate is calculated
Each of 76512’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 · 76512
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense0.89
0.89 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.4600
Conversion factor
$33.4009
Medicare rate
$48.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76512
The CMS indicators that decide how 76512 is paid alongside other services.
CMS payment indicators · 76512
Eye ultrasound
| 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) | 3 | Each side paid at 100% (no 150% cap). |
| 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
76512 without 26 · national office
$48.77
Eye ultrasound
76512-26 · Professional component
$30.39
Pays only the interpretation and report.
76512 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76510Eye ultrasound
- 76510 includes B-scan imaging with quantitative A-scan measurement; 76512 is for diagnostic B-scan imaging without that quantitative A-scan service.
- 76511Ocular ultrasound
- 76511 is quantitative A-scan only. Choose 76512 when the diagnostic service is B-scan imaging of the eye.
- 76513Eye ultrasound
- 76513 evaluates the anterior segment with ultrasound. 76512 is used for diagnostic B-scan imaging, typically of the posterior segment.
76512 billing questions
When should 76512 be selected instead of 76510?
Use 76512 for diagnostic B-scan imaging. Use 76510 when the service includes both B-scan imaging and quantitative A-scan measurement.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Without either modifier, the claim represents the global service.
How is the code reported when both eyes are scanned?
CMS pays each side separately at 100%. Documentation should identify which eye was examined.
Does the multiple-procedure reduction affect the interpretation?
The ophthalmology diagnostic multiple-procedure reduction applies to the technical component when multiple applicable procedures are performed.
What documentation supports a diagnostic B-scan?
Record the clinical reason for imaging, the eye examined, the ultrasound findings, and the interpretation. Examples of indications include an obscured posterior view or evaluation for suspected retinal detachment.
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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