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See a sample rate comparisonCPT 76513 Fee Schedule
Last Verified: September 2026
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.
Oph Us Dx Ant Sgm Us Uni Bi, Ophthalmic Ultrasound Diagnostic Anterior Segment Ultrasound Immersion Water Bath B Scan Or High Resolution Biomicroscopy Unilateral Or Bilateral
| 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 76513 |
| Medicaid Fee Schedule | View Medicaid rates for 76513 |
National average reimbursement for CPT 76513 by major payers:
$111.76
$111.81
$100.03
$122.05
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CPT 76513
5 of 25 sample ratesHigher to lower in this preview
Robert Mcleroy
Northern Arizona Healthcare Corporation
$139.19Published rateBaycare Home Care, Inc., Dba Sarasota Memorial Home Care
Baycare Home Care Inc
$111.59Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$68.87Published rateJonathan Weiser
Northern Arizona Healthcare Corporation
$55.20Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$24.18Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76513 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76513 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 76513 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 | Oph Us Dx B Scan Quan A Scan, Ophthalmic Ultrasound Diagnostic B Scan And Quantitative A Scan Performed During The Same Patient Encounter |
| 76511-CPT | Low | Ophthalmic Ultrasound Echogra, Ophthalmic Ultrasound Echography Diagnostic A-Scan Only With Amplitude Quantification |
| 76512-CPT | Low | Ophthalmic Ultrasound Echogra, Ophthalmic Ultrasound Echography Diagnostic Contactb-Scan (With Or Without Simultaneous A-Scan) |
| 76513-CPT | Low | Oph Us Dx Ant Sgm Us Uni Bi, Ophthalmic Ultrasound Diagnostic Anterior Segment Ultrasound Immersion Water Bath B Scan Or High Resolution Biomicroscopy Unilateral Or Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76513. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76513 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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