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See a sample rate comparisonCPT 76516 Fee Schedule
Medicare rates as of October 2026
CPT 76516 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
Biometry By Ultras. Echo.;A Scan
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $47.76 national non-facility rate (2026) · View Medicare rates for 76516 |
| Medicaid Fee Schedule | $38.655 median of the 8 states in the free preview · View Medicaid rates for 76516 |
National average reimbursement for CPT 76516 by major payers:
$77.55
BCBS / Anthem
$70.96
UnitedHealthcare
$65.13
Aetna
$81.84
Cigna
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CPT 76516
5 of 25 sample ratesHigher to lower in this preview
Charles Phelps
Radiology Associates Of North Texas, PA
$200.30Published rateJeremy Payne
Northern Arizona Healthcare Corporation
$65.38Published rateJohn Jesseph
Northern Arizona Healthcare Corporation
$45.59Published rateChristopher Raio
St Joseph Hospital
$28.34Published rateImani Rosario
Northern Arizona Healthcare Corporation
$23.45Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76516 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76516. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 76516-CPT | Low | Biometry By Ultras. Echo.;A Scan |
| 76519-CPT | Low | Ophthalmic Biometry By Ultrasou Echography A-Scan; W/ Ntraocular, Ophthalmic Biometry By Ultrasound Echography A-Scan; With Intraocular |
| 76529-CPT | Low | Ophthalmic U/S For.Body Localizatn |
| 76536-CPT | Low | Ultrasound Of Head And Neck, Ultrasound (Images With Sound Waves) Of The Thyroid Parathyroid Or Parotid Glands. These Glands Are In The Neck And Mouth. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76516 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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