How much does Medicare pay for CPT 70220?

Medicare allowed an average of $27.63 per service and paid $19.63 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $89.71, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 70220?

X-ray of paranasal sinus, minimum of 3 views. It was billed 14,170 times to 12,863 Medicare beneficiaries by 480 providers in 2024.

Does 70220 pay differently in an office than a hospital?

Yes. The allowed amount averaged $29.30 in an office setting and $9.98 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 70220 most?

Diagnostic Radiology, with 4,570 services from 226 clinicians. Next are Otolaryngology, Family Practice, Internal Medicine.

CPT 70220

X-ray of paranasal sinus, minimum of 3 views

$27.63Medicare-allowed amount per service, averaged across 14,170 services

Providers submitted

$89.71

Asking price, not received

Medicare allowed

$27.63

The fee schedule figure

Medicare paid

$19.63

Balance is patient coinsurance

Providers submitted an average of $89.71 for this code and Medicare allowed $27.63 — 3.2× 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 $19.63 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $29.30
Hospital / facility: $9.98

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. 12,947 services were billed in an office setting and 1,223 in a facility.

Services: 14,170
Beneficiaries: 12,863
Providers billing it: 480
Total allowed: $391,517

What Medicare pays for CPT 70220

Across 14,170 services billed by 480 providers to 12,863 beneficiaries, Medicare allowed an average of $27.63 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 70220

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	4,570	4,264	$20.61	226
Otolaryngology	2,153	1,884	$33.78	34
Family Practice	1,943	1,663	$31.22	66
Internal Medicine	1,629	1,428	$27.83	58
Nurse Practitioner	1,256	1,147	$27.20	25
Oral Surgery (Dentist only)	603	600	$35.89	12
Dentist	480	475	$35.51	10
Maxillofacial Surgery	410	403	$34.52	4
Independent Diagnostic Testing Facility (IDTF)	408	385	$29.42	20
Portable X-Ray Supplier	220	134	$18.40	4
Physician Assistant	123	123	$29.89	4
Pulmonary Disease	89	89	$28.79	5
Rheumatology	76	70	$27.53	2
Pain Management	65	65	$31.89	1
Emergency Medicine	51	48	$31.94	3

70220 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
Alabama	2,336	$28.66	$23.65	64
Tennessee	1,966	$21.14	$16.36	36
Texas	1,293	$29.07	$21.95	52
California	913	$35.86	$22.88	46
New York	834	$31.45	$20.20	24
Arizona	749	$33.96	$27.41	16
Virginia	629	$31.31	$23.72	11
Louisiana	579	$26.69	$21.91	20
Florida	575	$31.34	$24.31	24
Missouri	467	$27.95	$20.65	21
North Carolina	368	$21.42	$16.12	17
Pennsylvania	324	$19.37	$15.08	14
Arkansas	300	$19.02	$15.18	11
Maryland	297	$30.24	$21.24	8
Georgia	256	$28.02	$21.54	12
Mississippi	215	$24.49	$19.05	9
Kansas	210	$22.34	$18.39	7
Ohio	193	$18.89	$14.76	8
Oklahoma	167	$17.35	$13.26	8
New Jersey	157	$40.99	$26.90	8
Massachusetts	147	$16.05	$10.88	8
Michigan	140	$35.42	$27.23	6
Illinois	138	$24.05	$17.27	8
South Carolina	119	$31.81	$23.75	6
Indiana	119	$14.65	$10.04	8
Colorado	104	$29.95	$21.09	2
Nebraska	86	$33.38	$28.10	1
Nevada	84	$31.13	$24.06	3
Washington	65	$19.70	$11.98	2
Delaware	59	$36.06	$22.73	3
Rhode Island	56	$35.24	$24.63	3
Minnesota	33	$10.36	$6.59	2
West Virginia	31	$14.86	$7.18	2
Hawaii	31	$24.83	$14.70	2
Puerto Rico	30	$36.73	$25.70	2
Guam	22	$40.03	$23.10	1
Connecticut	21	$39.84	$29.40	1
New Mexico	17	$34.37	$21.48	1
Montana	15	$9.71	$6.22	1
Oregon	13	$39.66	$18.14	1
Wisconsin	12	$10.37	$6.70	1

Related codes

70250X-ray of skull$17.28
70210X-ray of paranasal sinus$23.09
70260X-ray of skull$26.97

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.