What Is CPT Code 76512?
CPT 76512 is the billing code for diagnostic ophthalmic ultrasound using B-scan imaging, with or without a superimposed non-quantitative A-scan. It is used when an ophthalmologist needs to visualize intraocular and orbital structures that cannot be directly examined, most commonly when a dense cataract, vitreous hemorrhage, or corneal opacity blocks the view. The code covers one eye and requires modifier RT or LT to identify the eye tested.
Unilateral billing: CPT 76512 is a unilateral code with a bilateral surgery indicator of 3 in the Medicare Physician Fee Schedule. Bill each eye separately using modifier RT (right) or LT (left). For bilateral studies, submit two line items or append modifier 50, depending on payer preference.
NCCI bundling: The NCCI bundles 76512 into 76510 (B-scan with quantitative A-scan). If the provider performs both a B-scan and a quantitative A-scan in the same encounter, bill 76510, not 76512 plus 76511 separately.
Supervision requirement: The technical component (76512-TC) requires direct provider supervision. The ordering physician or a physician in the group practice must be present in the office suite and available to provide guidance during the study.
What CPT 76512 Covers
CPT 76512 sits in the Diagnostic Ultrasound Procedures section of the CPT code set, under the ophthalmic ultrasound family that runs from 76510 through 76519. Its official AMA descriptor is “Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan).”
The B-scan uses brightness-amplitude ultrasound to create a two-dimensional cross-sectional image of the eye. A probe is placed against the closed eyelid or the anesthetized surface of the eye, and the oscillating sound beam produces echoes that render as a grayscale image on screen. The clinician uses this image to evaluate structures behind a media opacity, diagnose retinal detachments, identify intraocular tumors, locate foreign bodies, and assess vitreous pathology.
The “with or without superimposed non-quantitative A-scan” language in the descriptor means that if the provider runs an A-scan alongside the B-scan for echo-amplitude visualization (not for biometric measurement), the service still falls under 76512. The A-scan must be non-quantitative. If the A-scan produces a formal measurement (axial length, lesion height with quantification), the encounter escalates to 76510 or 76511 depending on the study performed.
One question we hear constantly from ophthalmology practice managers is whether their B-scan documentation supports the code they billed. In our experience matching providers with billing partners, the answer depends on whether the report clearly states what the scan showed and why it was medically necessary. A B-scan ordered “to evaluate posterior segment” with no documented obstruction or clinical indication is the kind of claim that triggers a medical necessity denial. For practices also billing ICD-10 code H52.03 for myopia management, pairing the correct diagnosis with the correct imaging code is the same documentation principle.
How CPT 76512 Differs From 76510, 76511, and 76519
The ophthalmic ultrasound family contains several codes that overlap in name but describe clinically distinct studies. Billing the wrong one is one of the most common errors in ophthalmology radiology coding, and it triggers both denials and NCCI edit rejections.
| CPT Code | Descriptor | A-Scan Type | When to Use |
|---|---|---|---|
| 76510 | B-scan and quantitative A-scan, same encounter | Quantitative (biometric measurement) | Both B-scan and quantitative A-scan performed together (e.g., tumor height measurement) |
| 76511 | Quantitative A-scan only | Quantitative only | Standalone quantitative A-scan without B-scan |
| 76512 | B-scan (with or without non-quantitative A-scan) | Non-quantitative or none | B-scan only, or B-scan with echo-amplitude A-scan (no measurement) |
| 76516 | Ophthalmic biometry, A-scan | Biometric (axial length) | A-scan for axial length without IOL calculation |
| 76519 | A-scan with IOL power calculation | Biometric (axial length + IOL formula) | Pre-cataract surgery biometry with IOL power determination |
The critical NCCI bundling rule: CPT codes 76511 and 76512 are bundled into 76510. If the provider performs both a B-scan and a quantitative A-scan in the same patient encounter, the correct code is 76510, not 76512 and 76511 billed as two separate lines. Billing them separately triggers an NCCI edit denial.
The simplest decision rule is this: if the A-scan produced a number (a measurement of any kind), it was quantitative, and 76512 is the wrong code. If the A-scan was used only for visual echo-amplitude assessment with no measurement output, or if no A-scan was performed at all, 76512 is correct.
How to Bill CPT 76512 for Bilateral Studies
CPT 76512 has a bilateral surgery indicator of 3 in the Medicare Physician Fee Schedule Database (MPFSDB), which means it is a unilateral code that is payable per eye. This is one of the few ophthalmology diagnostic codes that still carries unilateral payment, and it is the source of significant underbilling when practices fail to bill each eye separately.
When the B-scan is performed on one eye, submit 76512 with modifier RT (right eye) or LT (left eye). When both eyes are scanned in the same encounter, you have two options depending on payer preference:
Option 1: Two line items, one with modifier RT and one with modifier LT, each with one unit. This is the most widely accepted format.
Option 2: One line item with modifier 50 (bilateral procedure) and one unit. Some Medicare Administrative Contractors (MACs) prefer this format.
Correct payment for a bilateral study is 200% of the single-eye allowable. There is no 50% reduction for the second eye on this code, which is the standard bilateral payment rule for indicator-3 codes. Verify your MAC’s preference before submitting, because the format varies and using the wrong one generates unnecessary denials.
Across the billing companies we vet, the most common bilateral billing error on 76512 is submitting the code once with no modifier at all. The payer pays for one eye, the practice never bills for the second, and the revenue gap is invisible because nobody audits unilateral imaging claims. A billing partner with ophthalmology experience catches this pattern during encounter audits and recovers the lost revenue retroactively where timely filing allows.
Split Billing: Technical and Professional Components
CPT 76512 is a code that supports split billing with modifier 26 (professional component) and modifier TC (technical component). This matters in any arrangement where the entity that owns the ultrasound equipment is not the same provider who interprets the study.
Global billing (no modifier): The provider owns the equipment, performs the scan, and interprets the results. Bill 76512 with no TC or 26 modifier. This is the standard in most solo and group ophthalmology practices.
Technical component (76512-TC): The facility or practice owns the equipment and employs the technician who performs the scan, but a different provider interprets the results. The TC captures the equipment cost and the technician’s work. Important: 76512-TC requires direct provider supervision, meaning the ordering physician or a group practice physician must be physically present in the office suite during the study.
Professional component (76512-26): The interpreting physician reads the scan and writes the report but did not own the equipment or perform the technical work. The 26 modifier captures the physician’s interpretation and reporting.
The supervision requirement on the TC is the detail that causes the most compliance exposure. If the practice bills 76512-TC and the supervising physician was not in the suite, the claim is non-compliant. Providers often come to us after a MAC audit flags this exact issue, and the remediation involves both a refund and a documentation process overhaul.
Ophthalmic ultrasound billing looks simple until the NCCI edits fire, the bilateral modifier is wrong, or the TC supervision requirement catches up with you. If your B-scan claims are leaving revenue on the table or generating preventable denials, an ophthalmology billing partner catches the errors your team does not have time to audit.
Which ICD-10 Codes Support Medical Necessity for 76512?
Every 76512 claim must be supported by a diagnosis code that establishes medical necessity for the B-scan. The B-scan is a diagnostic study, so the diagnosis must explain why the provider could not evaluate the posterior segment or orbital structures through direct examination.
Common ICD-10 pairings for CPT 76512 in ophthalmology include:
- H43.1x (vitreous hemorrhage): The hemorrhage obscures the view, and the B-scan visualizes the retina behind it.
- H25.x / H26.x (cataract, various types): A dense or mature cataract blocks the fundus view, requiring ultrasound to evaluate the posterior segment before surgery.
- H33.x (retinal detachment): B-scan confirms or rules out detachment when direct visualization is not possible.
- H44.x (intraocular tumors): B-scan characterizes the lesion’s size, shape, and internal reflectivity.
- T15.x (foreign body in eye): B-scan localizes the foreign body when the media is too opaque for direct examination.
- S05.x (open wound of eye): Trauma assessment when the anterior segment is disrupted.
The most common denial pattern we see on 76512 is a claim paired with a routine exam diagnosis (Z01.00 or Z01.01) rather than a pathology code. A B-scan ordered during a routine eye exam without documented pathology or media opacity does not meet medical necessity. For practices navigating the full range of ophthalmology billing, our guide to finding the right ophthalmology medical billing service covers how to evaluate a billing partner’s diagnostic coding expertise.
CPT 76512 Medicare Reimbursement in 2026
Under the 2026 Medicare Physician Fee Schedule, CPT 76512 carries a work RVU of 0.55 and a total RVU of 1.46 (identical in facility and non-facility settings). The national Medicare payment estimate is approximately $48.77 before GPCI geographic adjustments. The global period is XXX, meaning there is no surgical global period attached to this code.
Commercial payer negotiated rates for 76512 are typically higher. Nationwide data from July 2026 shows a median negotiated rate of approximately $79 from physician practices and approximately $123 from facility settings, though rates range widely by payer and geography.
For bilateral studies (both eyes), correct billing at 200% of the single-eye allowable produces approximately $97.54 from Medicare and approximately $158 from the median commercial rate. That second-eye payment is the revenue most commonly left on the table when practices fail to append RT/LT modifiers on bilateral scans.
What Documentation Does a 76512 Claim Require?
The B-scan report must contain the clinical elements that support the code billed, the medical necessity for the study, and the findings that the interpreting physician identified. Clean documentation protects the claim from both front-end denials and post-payment audit recoupments.
Every 76512 report should include:
1. The clinical indication for the study (e.g., dense cataract preventing fundus view, vitreous hemorrhage, suspected retinal detachment).
2. The eye tested (right, left, or both) and the technique used (contact B-scan, immersion B-scan).
3. A description of the findings: vitreous status, retinal position, presence or absence of masses, foreign bodies, or detachments.
4. If a non-quantitative A-scan was superimposed, a statement confirming no biometric measurements were taken.
5. The interpreting physician’s signature and the date of interpretation.
The biggest issue we see providers run into is a report that states “B-scan performed, normal” with no description of findings and no clinical indication. This documentation does not support the code and will not survive a medical records request. The about us page explains how we connect practices with billing partners whose quality checks include imaging documentation review before claims are submitted.
Next Steps
Billing other ophthalmic imaging? Review our guide on ICD-10 H52.03 for bilateral myopia for correct diagnosis pairing on refractive imaging studies.
Evaluating your billing operation? Our guide on how to find the right ophthalmology medical billing service walks through the criteria that separate strong billing partners from average ones.
Ready to stop losing revenue on ophthalmic imaging claims? Get matched with billing companies that specialize in ophthalmology coding and catch the modifier and documentation errors others miss.
Frequently Asked Questions
CPT 76512 is the billing code for diagnostic ophthalmic ultrasound using B-scan imaging, with or without a superimposed non-quantitative A-scan. It is used to visualize intraocular and orbital structures when the provider’s direct view is blocked by a media opacity such as a dense cataract or vitreous hemorrhage.
Per eye. CPT 76512 has a bilateral surgery indicator of 3, which means it is a unilateral code. Bill each eye separately with modifier RT or LT. For bilateral scans, submit two line items (RT and LT) or one line with modifier 50, depending on payer preference. Correct bilateral payment is 200% of the single-eye allowable.
CPT 76512 covers a B-scan with or without a non-quantitative A-scan. CPT 76510 covers a B-scan performed with a quantitative A-scan in the same encounter. If the A-scan produced any biometric measurement, bill 76510. The NCCI bundles 76511 and 76512 into 76510, so billing them separately triggers a denial.
Yes. Because 76512 is a unilateral code, every claim must identify which eye was tested using modifier RT (right) or LT (left). Submitting 76512 without an eye modifier results in payment for only one eye and prevents correct bilateral billing.
Modifier TC on 76512 reports the technical component, which covers the equipment, supplies, and technician work for performing the B-scan. The TC requires direct provider supervision: a physician must be present in the office suite during the study. The professional component (modifier 26) covers the physician’s interpretation and report.
Under the 2026 Medicare Physician Fee Schedule, CPT 76512 pays approximately $48.77 per eye (national estimate before GPCI adjustment). The work RVU is 0.55 and the total RVU is 1.46. The global period is XXX. Commercial payer rates are typically higher, with a nationwide median around $79 from physician practices.
Common ICD-10 codes that support 76512 include H43.1x (vitreous hemorrhage), H25.x and H26.x (cataracts blocking fundus view), H33.x (retinal detachment), H44.x (intraocular tumors), and T15.x (ocular foreign body). The diagnosis must explain why the posterior segment could not be evaluated through direct examination.
Yes. CPT 76512 can be billed alongside an E/M code (such as 99213 or 99214) on the same date of service. The B-scan is a separate diagnostic study, not part of the eye exam. No special modifier is needed on the imaging code, though the E/M may require modifier 25 if a procedure was also performed the same day.
Stop losing revenue on ophthalmic ultrasound claims. Get matched with trusted ophthalmology billing companies that catch bilateral modifier errors, NCCI edit denials, and documentation gaps before they cost you. Ophthalmology Bill Co has connected more than 200 providers across all 50 states, with billing partners maintaining average Google ratings above 4.7. Finding a match is 100% free for providers.
