How much does Medicare pay for HCPCS 0640T?

Medicare allowed an average of $24.13 per service and paid $19.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $205.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code 0640T?

Noncontact near-infrared spectroscopy with image acquisition, interpretation and report, first anatomic site. It was billed 24,004 times to 2,137 Medicare beneficiaries by 61 providers in 2024.

Does 0640T pay differently in an office than a hospital?

Yes. The allowed amount averaged $24.96 in an office setting and $2.48 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 0640T most?

Nurse Practitioner, with 17,961 services from 36 clinicians. Next are Physician Assistant, Podiatry, Family Practice.

HCPCS 0640T

Noncontact near-infrared spectroscopy with image acquisition, interpretation and report, first anatomic site

$24.13Medicare-allowed amount per service, averaged across 24,004 services

Providers submitted

$205.78

Asking price, not received

Medicare allowed

$24.13

The fee schedule figure

Medicare paid

$19.15

Balance is patient coinsurance

Providers submitted an average of $205.78 for this code and Medicare allowed $24.13 — 8.5× 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 $19.15 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $24.96
Hospital / facility: $2.48

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. 23,114 services were billed in an office setting and 890 in a facility.

Services: 24,004
Beneficiaries: 2,137
Providers billing it: 61
Total allowed: $579,217

What Medicare pays for HCPCS 0640T

Across 24,004 services billed by 61 providers to 2,137 beneficiaries, Medicare allowed an average of $24.13 per service. That is 11.2 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 0640T

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	17,961	1,425	$25.89	36
Physician Assistant	4,217	230	$18.34	6
Podiatry	558	263	$20.52	9
Family Practice	545	94	$25.51	5
General Surgery	514	63	$12.02	2
Pediatric Medicine	104	27	$21.99	1
Plastic and Reconstructive Surgery	66	19	$2.74	1
Internal Medicine	39	16	$74.36	1

0640T 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 Jersey	17,522	$18.54	$14.91	18
Missouri	3,070	$63.34	$50.01	13
Texas	1,137	$5.93	$4.76	12
New York	955	$17.84	$15.34	1
Louisiana	480	$17.06	$13.36	3
Florida	317	$22.63	$17.84	4
California	174	$6.98	$5.46	1
Iowa	119	$64.15	$50.97	1
Indiana	61	$78.61	$61.61	2
Georgia	37	$67.92	$54.11	1
Arkansas	33	$35.44	$28.23	1
Michigan	31	$84.27	$62.89	1
Utah	28	$3.88	$2.82	1
Washington	26	$12.19	$9.72	1
Oklahoma	14	$20.56	$16.38	1

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.