How much does Medicare pay for CPT 71260?

Medicare allowed an average of $62.03 per service and paid $46.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $431.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 71260?

Ct scan of chest with contrast. It was billed 1,782,658 times to 1,675,889 Medicare beneficiaries by 20,603 providers in 2024.

Does 71260 pay differently in an office than a hospital?

Yes. The allowed amount averaged $83.92 in an office setting and $52.27 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 71260 most?

Diagnostic Radiology, with 1,612,499 services from 18,317 clinicians. Next are Interventional Radiology, Hematology-Oncology, Independent Diagnostic Testing Facility (IDTF).

CPT 71260

Ct scan of chest with contrast

$62.03Medicare-allowed amount per service, averaged across 1,782,658 services

Providers submitted

$431.38

Asking price, not received

Medicare allowed

$62.03

The fee schedule figure

Medicare paid

$46.91

Balance is patient coinsurance

Providers submitted an average of $431.38 for this code and Medicare allowed $62.03 — 7.0× 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 $46.91 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $83.92
Hospital / facility: $52.27

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. 550,041 services were billed in an office setting and 1,232,617 in a facility.

Services: 1,782,658
Beneficiaries: 1,675,889
Providers billing it: 20,603
Total allowed: $110,578,276

What Medicare pays for CPT 71260

Across 1,782,658 services billed by 20,603 providers to 1,675,889 beneficiaries, Medicare allowed an average of $62.03 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 71260

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,612,499	1,531,149	$60.35	18,317
Interventional Radiology	51,665	49,157	$61.27	742
Hematology-Oncology	36,256	29,211	$79.61	497
Independent Diagnostic Testing Facility (IDTF)	35,168	26,651	$101.26	346
Nuclear Medicine	12,892	10,666	$89.11	71
Medical Oncology	11,894	9,781	$73.60	185
Radiation Oncology	7,652	6,477	$71.72	126
Internal Medicine	3,654	3,180	$75.74	71
Family Practice	2,141	1,786	$79.42	55
Undefined Physician type	1,710	1,335	$79.15	4
Gynecological Oncology	842	706	$81.73	17
Emergency Medicine	764	702	$71.75	13
Urology	701	636	$60.42	33
Pediatric Medicine	579	535	$75.08	7
Pulmonary Disease	505	459	$86.42	22

71260 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	144,283	$72.29	$49.01	1,837
Texas	143,764	$59.44	$44.49	1,673
New York	110,384	$66.97	$44.91	1,131
Florida	99,435	$75.15	$56.29	1,158
Pennsylvania	82,214	$56.31	$41.17	929
Illinois	80,514	$59.89	$43.59	912
Massachusetts	71,722	$60.11	$41.53	559
Minnesota	64,881	$64.86	$47.94	798
North Carolina	63,255	$58.20	$44.64	723
Ohio	55,154	$54.90	$40.76	731
Virginia	54,612	$61.33	$45.53	522
Tennessee	52,456	$60.80	$47.77	536
Missouri	49,477	$54.43	$41.35	484
Michigan	49,196	$54.18	$39.92	616
Maryland	42,562	$78.84	$55.74	390
New Jersey	39,772	$70.40	$48.48	562
Georgia	37,731	$57.49	$43.33	558
Washington	37,281	$63.17	$44.49	437
Indiana	34,044	$54.52	$41.73	402
Arizona	32,626	$69.58	$52.33	381
South Carolina	32,410	$60.15	$46.37	357
Colorado	32,159	$60.25	$43.39	420
Wisconsin	31,735	$54.62	$40.47	460
Arkansas	26,105	$65.31	$53.58	213
Alabama	22,586	$59.99	$46.54	312
Oklahoma	22,058	$52.75	$40.37	230
Kansas	21,904	$54.33	$42.12	187
Iowa	20,726	$58.63	$44.94	196
Oregon	19,528	$57.14	$42.20	258
Kentucky	19,352	$54.25	$41.37	234
Nebraska	19,199	$54.20	$42.17	158
Connecticut	18,980	$61.52	$43.46	263
Mississippi	18,258	$53.64	$42.10	160
Louisiana	15,890	$54.48	$41.64	280
New Hampshire	10,665	$55.08	$40.06	131
Idaho	9,630	$53.56	$40.33	122
Nevada	8,766	$68.67	$51.26	168
West Virginia	8,758	$51.85	$37.75	119
Utah	8,753	$62.39	$47.69	151
Rhode Island	7,709	$59.76	$41.99	90
Delaware	7,118	$58.72	$42.70	56
New Mexico	6,932	$62.61	$46.87	105
Maine	6,725	$54.54	$38.95	105
District of Columbia	5,862	$69.17	$48.23	65
North Dakota	5,756	$52.22	$38.02	66
Montana	5,649	$56.91	$42.32	66
South Dakota	5,637	$53.16	$38.73	61
Alaska	4,918	$79.76	$47.95	60
Vermont	4,408	$53.25	$38.57	36
Hawaii	4,391	$61.81	$43.83	72
Wyoming	3,218	$58.28	$43.26	37
AA	462	$52.20	$38.53	3
Puerto Rico	330	$66.46	$48.58	10
XX	296	$65.80	$52.22	2
AP	216	$68.10	$47.47	3
Guam	152	$77.91	$53.83	5

Related codes

71250Ct scan of chest without contrast$66.48
71275Ct scan of blood vessels of chest$88.49
71271Low dose ct scan of chest for lung cancer screening$72.80
71270Ct scan of chest before and after contrast$107.04

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.