CPT 76519
Global XXX ActiveEcho exam of eye
CPT 76519 Billing & Documentation Guide
CPT code 76519 (Echo exam of eye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.53, a non-facility practice expense RVU of 1.53, and a malpractice RVU of 0.02, a total non-facility RVU of 2.08 and facility RVU of 2.08. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $71.97, though rates vary from $61.94 to $93.7 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76519, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 76519 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 76519 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 76519
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.53 | 0.53 |
| Practice Expense RVU | 1.53 | 1.53 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 2.08 | 2.08 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76519
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $79.17 | $79.17 | $74.37 - $93.7 | 29 |
| Florida | $70.28 | $70.28 | $67.56 - $72.59 | 3 |
| Georgia | $67.28 | $67.28 | $64.08 - $70.48 | 2 |
| Illinois | $68.42 | $68.42 | $65.4 - $71.49 | 4 |
| Michigan | $66.63 | $66.63 | $65.11 - $68.14 | 2 |
| North Carolina | $65.81 | $65.81 | $65.81 - $65.81 | 1 |
| New York | $76.46 | $76.46 | $66.72 - $80.84 | 5 |
| Ohio | $65.03 | $65.03 | $65.03 - $65.03 | 1 |
| Pennsylvania | $68.63 | $68.63 | $65.25 - $72.02 | 2 |
| Texas | $68.73 | $68.73 | $64.83 - $72.4 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 76519
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76519 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0689T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0690T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 76511 | Column 1 (primary), can be billed with modifier | 9 | Mutually exclusive procedures |
| 76513 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76516 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 76970 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76986 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76998 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 76519
What does CPT code 76519 mean? +
CPT code 76519 represents: Echo exam of eye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76519? +
The 2026 Medicare national average non-facility payment for CPT 76519 is $71.97. Rates range from $61.94 to $93.7 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76519? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 76519? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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