How much does Medicare pay for CPT 76000?

Medicare allowed an average of $27.31 per service and paid $21.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $382.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 76000?

Imaging guidance for procedure, 60 minutes or less. It was billed 92,402 times to 67,890 Medicare beneficiaries by 1,745 providers in 2024.

Does 76000 pay differently in an office than a hospital?

Yes. The allowed amount averaged $40.24 in an office setting and $17.92 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 76000 most?

Orthopedic Surgery, with 18,841 services from 448 clinicians. Next are Diagnostic Radiology, Independent Diagnostic Testing Facility (IDTF), Ambulatory Surgical Center.

CPT 76000

Imaging guidance for procedure, 60 minutes or less

$27.31Medicare-allowed amount per service, averaged across 92,402 services

Providers submitted

$382.98

Asking price, not received

Medicare allowed

$27.31

The fee schedule figure

Medicare paid

$21.31

Balance is patient coinsurance

Providers submitted an average of $382.98 for this code and Medicare allowed $27.31 — 14.0× 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 $21.31 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $40.24
Hospital / facility: $17.92

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. 38,870 services were billed in an office setting and 53,532 in a facility.

Services: 92,402
Beneficiaries: 67,890
Providers billing it: 1,745
Total allowed: $2,523,499

What Medicare pays for CPT 76000

Across 92,402 services billed by 1,745 providers to 67,890 beneficiaries, Medicare allowed an average of $27.31 per service. That is 1.4 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 76000

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	18,841	15,841	$26.26	448
Diagnostic Radiology	16,977	15,366	$16.24	373
Independent Diagnostic Testing Facility (IDTF)	16,255	4,687	$36.65	4
Ambulatory Surgical Center	11,681	10,926	$29.69	306
Podiatry	6,699	4,637	$36.28	133
Urology	5,232	4,351	$18.45	166
Hand Surgery	3,213	2,544	$37.29	46
Pain Management	2,335	921	$39.99	14
Neurosurgery	2,234	1,991	$14.42	51
Anesthesiology	1,938	920	$31.75	15
Clinical Cardiac Electrophysiology	1,132	1,100	$14.89	21
Plastic and Reconstructive Surgery	920	671	$39.59	26
Vascular Surgery	806	502	$28.24	9
Cardiology	659	640	$14.89	18
Interventional Pain Management	567	178	$37.93	5

76000 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	36,577	$34.02	$21.46	338
New York	6,955	$29.98	$19.86	144
Florida	6,584	$24.08	$18.93	142
Texas	4,467	$22.22	$17.37	120
New Jersey	4,117	$24.73	$17.61	78
Indiana	2,854	$18.53	$16.40	47
Arizona	2,560	$23.94	$19.04	69
Pennsylvania	1,810	$19.40	$14.71	55
Maryland	1,761	$21.54	$16.24	42
Virginia	1,443	$20.30	$15.94	43
Ohio	1,429	$20.27	$16.22	43
North Carolina	1,426	$25.76	$21.16	32
Oklahoma	1,376	$31.46	$28.83	11
Tennessee	1,269	$18.95	$15.97	39
South Carolina	1,251	$27.42	$22.31	17
Michigan	1,246	$19.52	$15.48	39
Colorado	1,208	$21.07	$15.98	33
Illinois	1,095	$23.38	$17.82	40
Massachusetts	924	$18.23	$13.50	30
Louisiana	881	$17.06	$13.67	24
Iowa	792	$19.14	$15.50	23
Delaware	784	$14.23	$10.96	18
Missouri	763	$18.31	$14.79	22
Nebraska	738	$13.23	$10.90	23
Alabama	721	$21.88	$18.30	19
Georgia	708	$25.43	$19.66	24
Mississippi	600	$21.63	$18.44	13
Washington	590	$19.41	$13.97	19
Kansas	560	$25.17	$20.42	13
Minnesota	510	$20.09	$15.41	20
Connecticut	481	$17.25	$12.55	22
Kentucky	426	$18.26	$14.49	18
Nevada	407	$20.24	$15.67	15
Oregon	400	$25.61	$18.20	14
North Dakota	396	$15.85	$12.90	17
West Virginia	388	$14.31	$10.70	8
Wisconsin	286	$17.79	$14.11	11
Wyoming	265	$19.44	$15.50	5
Idaho	252	$32.31	$26.91	8
Arkansas	193	$19.88	$16.89	10
Utah	184	$19.82	$15.89	9
New Hampshire	165	$19.49	$14.88	6
New Mexico	159	$27.32	$21.08	7
Montana	136	$14.42	$9.93	2
Alaska	98	$22.46	$13.81	6
South Dakota	65	$13.61	$10.98	2
District of Columbia	53	$15.48	$10.09	2
Rhode Island	26	$14.84	$10.94	2
Hawaii	23	$45.78	$32.57	1

Related codes

76098X-ray of surgical specimen$15.67
76080Review by radiologist of abscess or sinus cavity study$24.07

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.