How much does Medicare pay for CPT 49465?

Medicare allowed an average of $30.29 per service and paid $23.37 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $195.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49465?

Contrast injection for x-ray imaging through existing tube in stomach, small bowel or large bowel. It was billed 1,437 times to 1,298 Medicare beneficiaries by 76 providers in 2024.

Which specialty bills 49465 most?

Diagnostic Radiology, with 1,359 services from 71 clinicians. Next are Interventional Radiology, Radiation Oncology, Pain Management.

CPT 49465

Contrast injection for x-ray imaging through existing tube in stomach, small bowel or large bowel

$30.29Medicare-allowed amount per service, averaged across 1,437 services

Providers submitted

$195.89

Asking price, not received

Medicare allowed

$30.29

The fee schedule figure

Medicare paid

$23.37

Balance is patient coinsurance

Providers submitted an average of $195.89 for this code and Medicare allowed $30.29 — 6.5× 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 $23.37 (77%); the rest is the patient’s coinsurance and deductible.

Services: 1,437
Beneficiaries: 1,298
Providers billing it: 76
Total allowed: $43,527

What Medicare pays for CPT 49465

Across 1,437 services billed by 76 providers to 1,298 beneficiaries, Medicare allowed an average of $30.29 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 49465

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,359	1,227	$30.22	71
Interventional Radiology	44	40	$31.18	3
Radiation Oncology	17	16	$33.97	1
Pain Management	17	15	$29.58	1

49465 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 York	334	$33.96	$20.28	12
Louisiana	173	$28.05	$21.39	7
Florida	156	$30.16	$20.70	9
Texas	126	$28.36	$20.98	8
Delaware	102	$29.11	$21.01	6
Mississippi	99	$26.48	$18.97	5
Maryland	76	$30.84	$20.73	5
California	72	$32.91	$22.18	5
Massachusetts	51	$29.54	$20.43	3
Colorado	34	$29.57	$22.51	2
Illinois	28	$28.71	$18.99	2
Michigan	28	$29.15	$21.28	2
Tennessee	27	$27.53	$21.04	2
Iowa	26	$28.50	$21.80	1
Connecticut	24	$30.03	$17.37	1
North Carolina	16	$28.67	$19.64	1
Vermont	15	$33.06	$20.11	1
Arkansas	14	$26.46	$18.34	1
Oklahoma	13	$28.26	$21.43	1
Virginia	12	$28.48	$22.17	1
New Jersey	11	$34.12	$21.06	1

Related codes

49406Drainage of fluid collection of abdominal cavity by tube$178.72
49450Replacement of stomach or large bowel tube$270.04
49440Insertion of stomach tube$197.64
49424Injection of contrast through abdominal cavity tube for x-ray study$32.06
49452Replacement of stomach-to-small bowel tube$126.41
49422Removal of abdominal cavity tube$332.37

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.