CPT 76529: Eye ultrasoundMedicare rate & RVUs in Texas
Diagnostic ultrasound imaging of the eye is reported for an ocular echography service documented under this code, with separate reporting for each side when bilateral.
Medicare pays $81.03–$91.01 for 76529 in the office in Texas, from Beaumont to Austin. 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 76529 covers
This service uses ultrasound to examine the eye for diagnostic purposes. Ophthalmologists and other qualified eye-care clinicians may perform or interpret ocular echography in an ophthalmology office, eye clinic, or facility. The documented examination should identify the eye or eyes studied and the diagnostic ultrasound service performed; the record should support choosing this code rather than a neighboring code for a specifically defined scan or measurement.
Report the service according to the documented work and applicable claim format. CMS recognizes a professional component for interpretation and a technical component for the equipment and staff; modifier 26 identifies the professional portion, modifier TC the technical portion, and no component modifier represents the global service. When both eyes are examined, CMS pays each side separately at 100%, so document laterality and report each side as required by the claim format.
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 76529 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$81.03 to $91.01
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $91.01 | Unavailable |
| Beaumont | $81.03 | Unavailable |
| Brazoria | $86.50 | Unavailable |
| Dallas | $86.93 | Unavailable |
| Fort Worth | $86.27 | Unavailable |
| Galveston | $86.68 | Unavailable |
| Houston | $87.23 | Unavailable |
| Rest Of Texas | $83.64 | Unavailable |
How the 76529 rate is calculated
Each of 76529’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 · 76529
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.56Practice expense 2.02Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76529
The CMS indicators that decide how 76529 is paid alongside other services.
CMS payment indicators · 76529
Eye ultrasound
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
76529 without 26 · national office
$87.18
Eye ultrasound
76529-26 · Professional component
$32.06
Pays only the interpretation and report.
76529 compared with similar codes
Compare codes
76529 vs 76510 vs 76512 vs 76513 vs 76519: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76510Eye ultrasound
- 76510 identifies a combined B-scan and quantitative A-scan service. Use it when both scan types are documented rather than reporting the broader diagnostic eye ultrasound service under 76529.
- 76512Eye ultrasound
- 76512 is specifically for B-scan imaging. Select it when the documented examination is that defined scan.
- 76513Eye ultrasound
- 76513 is for ultrasound examination of the anterior segment. Distinguish it from 76529 by the documented anatomy and service.
- 76519Ocular biometry
- 76519 reports ocular ultrasound biometry with intraocular lens power calculation, typically in cataract surgical planning. It is not a general diagnostic eye ultrasound.
76529 billing questions
How should this code be distinguished from 76510, 76511, and 76512?
Check the documented ultrasound technique and service. Those neighboring codes identify B-scan with quantitative A-scan, quantitative A-scan alone, and B-scan alone, respectively; use a specifically defined code when the documented service matches it.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, which includes equipment and staff. Without either component modifier, the claim represents the global service.
How is bilateral testing reported?
CMS pays each side separately at 100% when the service is performed bilaterally. Document which eye was examined and follow the applicable claim format for reporting each side.
Is this interchangeable with ocular biometry codes 76516 or 76519?
No. Those codes describe ocular biometry by ultrasound, with 76519 including intraocular lens power calculation. Choose based on whether the documented service is biometry or the diagnostic eye ultrasound reported under 76529.
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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