How much does Medicare pay for CPT 75984?

Medicare allowed an average of $36.29 per service and paid $28.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $204.28, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 75984?

Review by radiologist of image for replacement of stomach or large bowel tube. It was billed 5,379 times to 3,333 Medicare beneficiaries by 205 providers in 2024.

Does 75984 pay differently in an office than a hospital?

Yes. The allowed amount averaged $88.04 in an office setting and $36.18 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 75984 most?

Diagnostic Radiology, with 2,365 services from 94 clinicians. Next are Interventional Radiology, Physician Assistant, Vascular Surgery.

CPT 75984

Review by radiologist of image for replacement of stomach or large bowel tube

$36.29Medicare-allowed amount per service, averaged across 5,379 services

Providers submitted

$204.28

Asking price, not received

Medicare allowed

$36.29

The fee schedule figure

Medicare paid

$28.25

Balance is patient coinsurance

Providers submitted an average of $204.28 for this code and Medicare allowed $36.29 — 5.6× 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 $28.25 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $88.04
Hospital / facility: $36.18

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 services were billed in an office setting and 5,367 in a facility.

Services: 5,379
Beneficiaries: 3,333
Providers billing it: 205
Total allowed: $195,204

What Medicare pays for CPT 75984

Across 5,379 services billed by 205 providers to 3,333 beneficiaries, Medicare allowed an average of $36.29 per service. That is 1.6 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 75984

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	2,365	1,460	$37.00	94
Interventional Radiology	2,269	1,491	$37.12	91
Physician Assistant	583	279	$30.48	14
Vascular Surgery	63	27	$35.81	1
Cardiology	34	24	$37.13	1
Nurse Practitioner	31	28	$30.39	2
Undefined Physician type	21	12	$35.94	1
Interventional Cardiology	13	12	$38.04	1

75984 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
Minnesota	864	$36.23	$28.15	23
Pennsylvania	530	$37.32	$28.55	23
California	360	$40.22	$28.19	17
Iowa	314	$30.51	$25.13	5
Wisconsin	298	$34.79	$28.34	12
Florida	271	$36.76	$28.38	10
Missouri	268	$32.32	$25.59	7
South Dakota	227	$36.85	$28.27	7
Illinois	214	$39.33	$28.76	7
Arizona	205	$36.26	$28.69	10
North Dakota	186	$35.81	$27.35	4
New Jersey	168	$39.15	$28.71	7
Massachusetts	149	$37.10	$27.66	8
Idaho	123	$35.08	$28.91	5
North Carolina	120	$40.08	$33.23	7
Ohio	103	$36.52	$28.87	4
Arkansas	99	$34.40	$28.84	5
Washington	94	$37.90	$28.57	4
Virginia	88	$39.82	$29.09	3
Maryland	84	$37.54	$28.78	4
Georgia	84	$32.45	$25.27	5
Texas	73	$36.73	$28.36	5
New Hampshire	68	$35.92	$27.53	4
Tennessee	67	$34.54	$27.84	4
Louisiana	60	$35.52	$27.60	1
Indiana	52	$33.86	$28.79	3
Kansas	50	$35.73	$28.14	3
Oregon	46	$34.50	$27.18	2
Rhode Island	37	$38.29	$27.58	1
South Carolina	32	$35.61	$26.54	2
New York	30	$36.75	$29.19	2
Nebraska	15	$32.94	$29.17	1

Related codes

75989Review by radiologist of image for drainage of fluid$75.63

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.