How much does Medicare pay for CPT 76512?

Medicare allowed an average of $52.75 per service and paid $39.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $204.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 76512?

2d ultrasound scan of eye tissue and structures. It was billed 174,257 times to 106,930 Medicare beneficiaries by 2,247 providers in 2024.

Does 76512 pay differently in an office than a hospital?

Yes. The allowed amount averaged $53.50 in an office setting and $32.99 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 76512 most?

Ophthalmology, with 141,778 services from 2,030 clinicians. Next are Optometry, Diagnostic Radiology, Physician Assistant.

CPT 76512

2d ultrasound scan of eye tissue and structures

$52.75Medicare-allowed amount per service, averaged across 174,257 services

Providers submitted

$204.12

Asking price, not received

Medicare allowed

$52.75

The fee schedule figure

Medicare paid

$39.96

Balance is patient coinsurance

Providers submitted an average of $204.12 for this code and Medicare allowed $52.75 — 3.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $39.96 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $53.50
Hospital / facility: $32.99

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 167,838 services were billed in an office setting and 6,419 in a facility.

Services: 174,257
Beneficiaries: 106,930
Providers billing it: 2,247
Total allowed: $9,192,057

What Medicare pays for CPT 76512

Across 174,257 services billed by 2,247 providers to 106,930 beneficiaries, Medicare allowed an average of $52.75 per service. That is 1.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 76512

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	141,778	89,461	$53.10	2,030
Optometry	32,266	17,297	$51.28	211
Diagnostic Radiology	90	89	$49.51	1
Physician Assistant	44	21	$19.66	1
Nurse Practitioner	36	26	$40.57	1
Internal Medicine	16	11	$32.04	1
Neurology	14	13	$26.89	1
Gastroenterology	13	12	$48.50	1

76512 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	46,189	$64.21	$44.32	334
California	23,632	$52.14	$34.85	250
Florida	23,200	$53.46	$40.84	235
Maryland	13,290	$47.74	$35.31	80
New Jersey	10,152	$50.78	$43.41	108
Texas	10,035	$45.27	$42.66	142
Illinois	4,791	$47.47	$35.01	86
Pennsylvania	3,738	$45.74	$36.27	100
Massachusetts	3,579	$43.49	$29.15	66
Kansas	3,135	$41.52	$33.72	22
Tennessee	2,679	$42.47	$33.80	43
Louisiana	2,425	$41.33	$32.53	29
North Carolina	2,410	$44.57	$36.63	57
Virginia	2,306	$47.75	$35.27	55
Michigan	1,618	$46.26	$34.91	54
Georgia	1,615	$46.22	$35.32	42
Oregon	1,407	$41.88	$29.82	27
Arizona	1,377	$46.62	$36.47	38
Wisconsin	1,255	$40.73	$30.06	25
Minnesota	1,119	$50.30	$35.24	27
Missouri	1,098	$48.40	$35.86	33
Colorado	1,074	$48.86	$35.56	32
Washington	1,056	$44.53	$31.99	35
Ohio	1,022	$43.87	$33.68	44
Hawaii	882	$48.87	$34.32	14
Connecticut	784	$52.06	$36.29	25
South Carolina	773	$44.98	$38.31	28
Indiana	759	$45.81	$34.78	19
Oklahoma	696	$44.39	$36.07	20
Mississippi	554	$42.09	$39.87	14
Nevada	530	$47.06	$34.21	18
Kentucky	512	$48.35	$37.20	15
Puerto Rico	471	$49.08	$35.48	5
West Virginia	462	$40.66	$35.09	10
Alabama	398	$41.54	$35.15	15
Arkansas	391	$42.43	$37.05	13
Iowa	378	$35.45	$27.66	15
Nebraska	362	$40.82	$31.14	8
Rhode Island	305	$49.49	$35.35	11
Utah	249	$44.87	$35.01	7
District of Columbia	228	$47.74	$41.44	5
Montana	223	$48.58	$35.33	5
New Mexico	198	$44.21	$33.30	9
New Hampshire	163	$42.83	$31.86	5
North Dakota	161	$44.13	$33.38	4
Vermont	150	$38.59	$29.01	4
Maine	135	$38.61	$28.56	5
South Dakota	87	$47.18	$40.01	3
Idaho	57	$46.49	$33.67	1
Northern Mariana Islands	55	$31.48	$15.99	1
Alaska	40	$51.32	$30.20	2
Guam	35	$47.87	$25.14	1
Wyoming	17	$48.67	$37.35	1

Related codes

76536Ultrasound scan of head and neck soft tissue$67.45
76514Ultrasound scan of cornea to determine thickness$10.70
76519Ultrasound scan to determine eye length and lens power$49.07
765101d and 2d ultrasound scan of eye tissue and structures$64.45
76513Ultrasound scan of eye$96.62
765111d ultrasound scan of eye tissue and structures$57.36
76516Ultrasound scan to determine eye length$42.51

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.