How much does Medicare pay for HCPCS 0398T?

Medicare allowed an average of $1639.42 per service and paid $1304.33 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $8525.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code 0398T?

Destruction of tissue of brain using mri guidance. It was billed 1,358 times to 1,313 Medicare beneficiaries by 51 providers in 2024.

Does 0398T pay differently in an office than a hospital?

Yes. The allowed amount averaged $3179.02 in an office setting and $1496.98 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 0398T most?

Neurosurgery, with 1,256 services from 46 clinicians. Next are Diagnostic Radiology, Interventional Radiology, Physician Assistant.

HCPCS 0398T

Destruction of tissue of brain using mri guidance

$1639.42Medicare-allowed amount per service, averaged across 1,358 services

Providers submitted

$8525.98

Asking price, not received

Medicare allowed

$1639.42

The fee schedule figure

Medicare paid

$1304.33

Balance is patient coinsurance

Providers submitted an average of $8525.98 for this code and Medicare allowed $1639.42 — 5.2× 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 $1304.33 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $3179.02
Hospital / facility: $1496.98

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. 115 services were billed in an office setting and 1,243 in a facility.

Services: 1,358
Beneficiaries: 1,313
Providers billing it: 51
Total allowed: $2,226,332

What Medicare pays for HCPCS 0398T

Across 1,358 services billed by 51 providers to 1,313 beneficiaries, Medicare allowed an average of $1639.42 per service. 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 0398T

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	1,256	1,213	$1710.69	46
Diagnostic Radiology	44	44	$349.46	2
Interventional Radiology	30	28	$1667.79	1
Physician Assistant	14	14	$115.46	1
Neurology	14	14	$763.14	1

0398T 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
Virginia	165	$1938.68	$1558.02	5
Texas	124	$1757.91	$1403.13	3
Florida	107	$1729.55	$1356.19	4
California	105	$971.52	$765.21	6
New York	103	$1839.61	$1400.51	4
North Carolina	85	$3746.24	$3011.76	4
Massachusetts	82	$1596.11	$1260.67	2
Oregon	63	$854.20	$639.34	2
Maryland	61	$1567.00	$1276.74	2
Colorado	46	$847.08	$665.44	2
New Jersey	44	$1565.57	$1313.18	2
Arizona	43	$883.60	$696.07	1
Washington	42	$634.23	$502.16	2
Oklahoma	40	$1685.71	$1341.66	1
Pennsylvania	39	$1497.73	$1189.62	1
Illinois	35	$1683.75	$1331.52	1
Ohio	31	$2672.00	$2123.99	2
Utah	31	$142.29	$110.76	1
Tennessee	30	$1674.07	$1332.77	2
Georgia	23	$1527.34	$1364.73	1
Kentucky	22	$1543.12	$1228.77	1
Indiana	20	$1309.31	$1027.90	1
Kansas	17	$1366.13	$1038.07	1

Related codes

0394THigh dose rate electronic brachytherapy$186.47

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.