How much does Medicare pay for CPT 75565?

Medicare allowed an average of $15.27 per service and paid $11.94 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $124.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 75565?

Mri scan of blood flow of heart. It was billed 23,688 times to 18,235 Medicare beneficiaries by 455 providers in 2024.

Does 75565 pay differently in an office than a hospital?

Yes. The allowed amount averaged $33.26 in an office setting and $11.58 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 75565 most?

Cardiology, with 16,601 services from 266 clinicians. Next are Diagnostic Radiology, Internal Medicine, Independent Diagnostic Testing Facility (IDTF).

CPT 75565

Mri scan of blood flow of heart

$15.27Medicare-allowed amount per service, averaged across 23,688 services

Providers submitted

$124.35

Asking price, not received

Medicare allowed

$15.27

The fee schedule figure

Medicare paid

$11.94

Balance is patient coinsurance

Providers submitted an average of $124.35 for this code and Medicare allowed $15.27 — 8.1× 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 $11.94 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $33.26
Hospital / facility: $11.58

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. 4,039 services were billed in an office setting and 19,649 in a facility.

Services: 23,688
Beneficiaries: 18,235
Providers billing it: 455
Total allowed: $361,716

What Medicare pays for CPT 75565

Across 23,688 services billed by 455 providers to 18,235 beneficiaries, Medicare allowed an average of $15.27 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. 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 75565

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	16,601	11,866	$14.00	266
Diagnostic Radiology	5,059	4,762	$16.45	145
Internal Medicine	758	671	$11.53	21
Independent Diagnostic Testing Facility (IDTF)	647	328	$44.87	4
Interventional Radiology	203	203	$17.59	5
Advanced Heart Failure and Transplant Cardiology	117	106	$11.26	3
Adult Congenital Heart Disease	81	80	$11.92	3
Nuclear Medicine	70	70	$11.89	3
Interventional Cardiology	66	65	$11.14	2
Pediatric Medicine	37	37	$11.42	1
Radiation Oncology	28	28	$11.81	1
Hospitalist	21	19	$11.66	1

75565 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
Texas	4,338	$15.05	$11.66	27
North Carolina	2,346	$24.70	$20.45	26
Tennessee	2,134	$11.96	$9.45	20
Illinois	1,781	$12.37	$9.09	29
Ohio	1,734	$12.28	$9.66	46
California	1,349	$22.69	$15.97	32
Pennsylvania	1,285	$14.00	$11.21	30
Georgia	1,028	$11.57	$8.69	20
New York	939	$17.08	$11.32	24
Michigan	668	$11.41	$8.65	14
Minnesota	549	$11.31	$9.01	17
Virginia	538	$14.42	$10.30	17
Oklahoma	537	$11.09	$8.80	6
Indiana	535	$11.20	$8.99	15
Florida	446	$13.66	$10.48	14
Connecticut	441	$14.24	$10.41	14
Massachusetts	339	$13.06	$9.56	9
Wisconsin	300	$13.12	$10.70	12
Arizona	283	$11.42	$8.64	10
Missouri	279	$34.98	$29.00	5
Oregon	271	$12.10	$8.71	8
Colorado	254	$11.74	$8.90	7
Washington	201	$12.18	$8.78	8
New Hampshire	164	$11.39	$8.96	4
Kentucky	160	$11.29	$8.48	5
New Jersey	148	$12.39	$9.01	7
Alaska	87	$51.26	$36.76	2
Louisiana	85	$10.87	$9.15	2
Maryland	69	$12.22	$8.98	3
South Carolina	62	$11.27	$8.97	4
Utah	51	$29.11	$20.91	3
Alabama	44	$11.18	$9.12	2
South Dakota	41	$11.25	$8.87	1
Kansas	37	$11.23	$9.11	2
Mississippi	35	$11.26	$8.87	2
District of Columbia	31	$12.49	$9.12	2
North Dakota	31	$11.31	$9.10	2
West Virginia	30	$10.86	$9.17	1
Vermont	16	$11.51	$9.12	1
Rhode Island	11	$12.06	$9.12	1
Nevada	11	$11.40	$8.27	1

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
75561Mri scan of heart before and after contrast$154.34
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.