How much does Medicare pay for CPT 38792?

Medicare allowed an average of $27.96 per service and paid $21.93 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $306.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 38792?

Injection of radioactive material for x-ray identification of lymph node. It was billed 11,320 times to 11,275 Medicare beneficiaries by 546 providers in 2024.

Does 38792 pay differently in an office than a hospital?

Yes. The allowed amount averaged $58.07 in an office setting and $24.32 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 38792 most?

Diagnostic Radiology, with 5,564 services from 287 clinicians. Next are General Surgery, Surgical Oncology, Nuclear Medicine.

CPT 38792

Injection of radioactive material for x-ray identification of lymph node

$27.96Medicare-allowed amount per service, averaged across 11,320 services

Providers submitted

$306.07

Asking price, not received

Medicare allowed

$27.96

The fee schedule figure

Medicare paid

$21.93

Balance is patient coinsurance

Providers submitted an average of $306.07 for this code and Medicare allowed $27.96 — 10.9× 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 $21.93 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $58.07
Hospital / facility: $24.32

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. 1,220 services were billed in an office setting and 10,100 in a facility.

Services: 11,320
Beneficiaries: 11,275
Providers billing it: 546
Total allowed: $316,507

What Medicare pays for CPT 38792

Across 11,320 services billed by 546 providers to 11,275 beneficiaries, Medicare allowed an average of $27.96 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 38792

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	5,564	5,539	$35.05	287
General Surgery	3,481	3,471	$16.60	156
Surgical Oncology	1,037	1,032	$16.09	49
Nuclear Medicine	858	856	$42.41	33
Interventional Radiology	110	108	$31.11	5
Physician Assistant	73	72	$27.80	3
Obstetrics & Gynecology	57	57	$17.13	3
Hematology-Oncology	39	39	$15.63	2
Nurse Practitioner	29	29	$27.51	2
Gynecological Oncology	24	24	$15.98	2
Plastic and Reconstructive Surgery	23	23	$16.31	2
Independent Diagnostic Testing Facility (IDTF)	13	13	$75.52	1
Family Practice	12	12	$83.08	1

38792 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
California	994	$39.60	$22.83	48
Florida	950	$34.53	$21.53	39
Texas	835	$25.49	$16.49	42
Pennsylvania	746	$22.53	$15.50	35
New York	741	$28.00	$17.76	33
Ohio	573	$18.03	$13.57	28
Virginia	538	$27.98	$15.45	20
Arizona	489	$18.89	$13.78	18
Washington	426	$31.18	$17.56	21
Maryland	387	$37.69	$22.82	17
North Carolina	351	$21.70	$14.82	16
Tennessee	334	$37.08	$25.94	17
Illinois	311	$28.93	$16.38	18
Massachusetts	297	$23.27	$15.67	16
New Jersey	260	$28.32	$17.80	15
Kansas	216	$44.53	$33.52	10
Indiana	209	$20.72	$15.99	11
Georgia	201	$17.50	$13.51	11
Michigan	200	$30.80	$16.13	10
South Carolina	189	$26.26	$16.58	10
Kentucky	186	$22.53	$14.21	10
Colorado	169	$23.32	$15.47	9
Mississippi	165	$26.73	$14.79	7
Utah	159	$16.42	$13.46	5
Oklahoma	133	$24.48	$17.78	6
Louisiana	120	$21.49	$14.04	6
Wisconsin	118	$23.51	$16.63	7
Arkansas	113	$29.25	$21.67	7
Minnesota	109	$23.65	$15.55	6
Missouri	103	$29.55	$14.81	5
Delaware	87	$17.03	$13.28	4
New Hampshire	79	$25.62	$18.30	6
Iowa	76	$35.25	$29.20	3
District of Columbia	67	$17.52	$12.87	2
Oregon	63	$30.14	$17.14	4
Nebraska	55	$27.01	$17.27	4
Alabama	54	$22.09	$14.34	4
New Mexico	50	$50.48	$35.50	4
Connecticut	37	$24.99	$12.19	3
Vermont	32	$15.31	$12.55	2
North Dakota	30	$26.37	$21.02	1
West Virginia	22	$23.32	$12.94	2
Montana	12	$27.07	$16.45	1
Idaho	12	$14.95	$12.33	1
Alaska	11	$39.42	$23.65	1
Nevada	11	$25.83	$20.76	1

Related codes

38724Removal of lymph nodes$1212.91

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.