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See a sample rate comparisonCPT 76516 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.
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 | None 26 - Professional component RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76516 |
| Medicaid Fee Schedule | View Medicaid rates for 76516 |
National average reimbursement for CPT 76516 by major payers:
$77.55
$70.96
$65.13
$81.84
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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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See a sample payer proposalCPT 76516 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76516 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 76516 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 |
|---|---|---|
| 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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