CPT 76512 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Ultrasound Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76512 |
National average reimbursement for CPT 76512 by major payers:
$73.86
$86.27
$83.40
$97.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 76512 | ||||||
United | 76512 | $37.75 | 1689611691 - PARAG GANDHI | 621799761 - (TN) WESLEY KLIPPENSTEIN PC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $81.88 | 1700835535 - CHILDRENS EYE CARE LLC | 522172508 - (MD) CHILDRENS EYE CARE LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $40.22 | 1861484735 - EUGENE SALVO | 1861484735 - (MD) EUGENE SALVO | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $307.54 | 1619179264 - ADAM WENICK | 520595110 - JOHNS HOPKINS UNIVERSITY | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $30.44 | 1275626749 - THOMAS YAU | 562316444 - (MD) SILVER SPRING EYE LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $30.44 | 1275626749 - THOMAS YAU | 562316444 - (MD) SILVER SPRING EYE LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $43.45 | 1891965349 - LERNER MD PA | 521283525 - (MD) LERNER MD PA | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $42.97 | 1275536963 - MATTHEW SPEICHER | 208346981 - ASSOCIATED RETINAL CONSULTANTS, LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $49.77 | 1700182151 - SAYA NAGORI | 824585184 - (MD) VISIONMD LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $162.05 | 1740340058 - PETER MCDONNELL | 520595110 - JOHNS HOPKINS UNIVERSITY | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $25.03 | 1992902381 - OMAR CHAUDHARY | 833293743 - CAPITAL EYE CARE, LLC | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $46.11 | 1639187875 - MICHAEL J. DODD, M.D., P.A., MARYLAND EYE ASSOCIATES | 521658990 - (MD) MICHAEL J DODD MD PA | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $19.03 | 1639187875 - MICHAEL J. DODD, M.D., P.A., MARYLAND EYE ASSOCIATES | 521658990 - (MD) MICHAEL J DODD MD PA | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $398.45 | 1679708424 - MONA KALEEM | 520595110 - JOHNS HOPKINS UNIVERSITY | MD | Ophthalmology Physician (207W00000X) |
United | 76512 | $28.61 | 1134216708 - JENIFER AVENTURO | 522027093 - (MD) STEPHEN R GLASER MD PC | MD | Ophthalmology Physician (207W00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 76512 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76512 code is part of the Radiology Procedures services used for Diagnostic Ultrasound Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 76512 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 76510-CPT | Low | Opthalmic Ultrasound Diagnostic; B-Scan And Quantitive A-Scan Performed During The Same Patient Encounter |
| 76511-CPT | Low | Opthalmic Ultrasound, Echography, Diagnostic; A-Scan Only, With Ampliture Quantification |
| 76512-CPT | Low | Ophthalmic Ultrasound Echography Diagnostic; Contact B-Scan (With Or Without Simultaneous A-Scan) |
| 76513-CPT | Low | Ophthalmic Ultrasound Diagnostic; Anterior Segment Ultrasound Immersion (Water Bath) B-Scan Or High Resolution Biomicroscopy Unilateral Or Bilateral (Desc Rvsd 1/1/21) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76512. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76512 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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