How much does Medicare pay for CPT 75561?

Medicare allowed an average of $154.34 per service and paid $118.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $968.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 75561?

Mri scan of heart before and after contrast. It was billed 48,776 times to 47,593 Medicare beneficiaries by 1,220 providers in 2024.

Does 75561 pay differently in an office than a hospital?

Yes. The allowed amount averaged $280.90 in an office setting and $120.27 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 75561 most?

Cardiology, with 22,881 services from 528 clinicians. Next are Diagnostic Radiology, Internal Medicine, Independent Diagnostic Testing Facility (IDTF).

CPT 75561

Mri scan of heart before and after contrast

$154.34Medicare-allowed amount per service, averaged across 48,776 services

Providers submitted

$968.75

Asking price, not received

Medicare allowed

$154.34

The fee schedule figure

Medicare paid

$118.66

Balance is patient coinsurance

Providers submitted an average of $968.75 for this code and Medicare allowed $154.34 — 6.3× 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 $118.66 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $280.90
Hospital / facility: $120.27

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. 10,345 services were billed in an office setting and 38,431 in a facility.

Services: 48,776
Beneficiaries: 47,593
Providers billing it: 1,220
Total allowed: $7,528,088

What Medicare pays for CPT 75561

Across 48,776 services billed by 1,220 providers to 47,593 beneficiaries, Medicare allowed an average of $154.34 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 75561

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	22,881	22,424	$142.43	528
Diagnostic Radiology	21,460	20,771	$162.50	598
Internal Medicine	1,297	1,290	$119.91	39
Independent Diagnostic Testing Facility (IDTF)	1,145	1,136	$303.33	12
Interventional Radiology	510	506	$140.61	8
Nuclear Medicine	460	457	$129.54	7
Interventional Cardiology	316	314	$167.71	6
Advanced Heart Failure and Transplant Cardiology	268	268	$115.18	7
Adult Congenital Heart Disease	203	200	$120.82	5
Hospitalist	63	61	$120.47	1
Pediatric Medicine	55	48	$160.49	2
Clinical Cardiac Electrophysiology	50	50	$218.41	3
Radiation Oncology	39	39	$162.64	2
Critical Care (Intensivists)	18	18	$118.86	1
Neurology	11	11	$330.29	1

75561 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	4,035	$201.92	$136.13	86
New York	3,655	$207.81	$141.35	72
Pennsylvania	3,210	$136.60	$100.79	70
Illinois	2,936	$128.22	$91.13	68
Ohio	2,885	$125.42	$95.07	77
Virginia	2,651	$162.48	$116.23	45
Massachusetts	2,624	$147.24	$103.54	50
Texas	2,579	$147.08	$109.88	52
North Carolina	2,198	$158.41	$122.74	53
Florida	2,093	$162.75	$124.48	63
Minnesota	1,887	$189.61	$141.26	57
New Jersey	1,320	$148.20	$104.85	30
Wisconsin	1,230	$118.68	$88.65	37
Michigan	1,211	$118.94	$86.05	32
Georgia	1,168	$117.87	$87.02	38
Tennessee	1,149	$129.93	$98.72	27
Indiana	1,043	$114.30	$90.05	31
Washington	1,006	$162.76	$114.84	24
Missouri	907	$176.23	$139.74	29
Maryland	878	$204.13	$147.27	24
Connecticut	694	$141.93	$100.65	20
Arizona	692	$140.56	$105.25	19
Colorado	598	$147.38	$106.39	21
Utah	526	$181.09	$135.63	13
Oregon	488	$133.89	$97.76	13
Oklahoma	451	$114.10	$87.78	8
South Carolina	421	$133.39	$108.68	18
Kentucky	409	$116.87	$87.62	14
Alabama	357	$152.00	$120.25	14
District of Columbia	355	$142.34	$99.92	7
Idaho	353	$119.57	$94.44	10
Kansas	246	$115.32	$87.20	13
New Hampshire	209	$117.67	$89.03	5
Iowa	209	$164.65	$128.92	7
North Dakota	198	$115.79	$87.11	8
Nebraska	196	$113.19	$86.87	9
West Virginia	180	$122.02	$88.08	8
Vermont	178	$116.44	$87.56	5
Arkansas	177	$111.82	$88.64	7
Mississippi	155	$114.29	$91.39	5
Hawaii	153	$173.99	$125.86	2
Louisiana	143	$113.51	$92.15	4
Alaska	110	$421.38	$267.64	2
Rhode Island	107	$123.20	$86.22	3
Maine	104	$159.62	$128.79	4
Nevada	89	$214.94	$161.35	5
Montana	88	$117.56	$84.73	2
South Dakota	85	$114.44	$90.54	2
Delaware	74	$118.33	$88.18	2
New Mexico	41	$115.97	$92.57	3
Wyoming	25	$326.01	$278.84	2

Related codes

75574Ct scan of blood vessels and grafts of heart$157.89
75571Ct scan of heart$71.56
75572Ct scan of heart structure$94.71
75565Mri scan of blood flow of heart$15.27
75580Analysis of data from ct study of heart blood vessels to assess severi$343.33
75563Mri scan of heart before and after contrast$202.99

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.