How much does Medicare pay for CPT 76100?

Medicare allowed an average of $88.76 per service and paid $68.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $162.49, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 76100?

X-ray of body plane. It was billed 8,347 times to 6,176 Medicare beneficiaries by 72 providers in 2024.

Does 76100 pay differently in an office than a hospital?

Yes. The allowed amount averaged $92.98 in an office setting and $25.78 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 76100 most?

Independent Diagnostic Testing Facility (IDTF), with 3,248 services from 3 clinicians. Next are Oral Surgery (Dentist only), Urology, Maxillofacial Surgery.

CPT 76100

X-ray of body plane

$88.76Medicare-allowed amount per service, averaged across 8,347 services

Providers submitted

$162.49

Asking price, not received

Medicare allowed

$88.76

The fee schedule figure

Medicare paid

$68.81

Balance is patient coinsurance

Providers submitted an average of $162.49 for this code and Medicare allowed $88.76 — 1.8× 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 $68.81 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $92.98
Hospital / facility: $25.78

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. 7,822 services were billed in an office setting and 525 in a facility.

Services: 8,347
Beneficiaries: 6,176
Providers billing it: 72
Total allowed: $740,880

What Medicare pays for CPT 76100

Across 8,347 services billed by 72 providers to 6,176 beneficiaries, Medicare allowed an average of $88.76 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 76100

Specialty	Services	Beneficiaries	Avg allowed	Providers
Independent Diagnostic Testing Facility (IDTF)	3,248	2,925	$100.77	3
Oral Surgery (Dentist only)	1,346	717	$84.58	17
Urology	1,318	972	$92.95	15
Maxillofacial Surgery	917	527	$86.01	3
Dentist	807	393	$86.97	10
Diagnostic Radiology	525	521	$25.78	21
Pain Management	130	65	$75.57	1
General Practice	35	35	$86.44	1
Internal Medicine	21	21	$83.33	1

76100 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	4,126	$99.22	$68.03	15
Arizona	1,691	$85.04	$67.70	11
Texas	709	$84.82	$67.50	8
Washington	564	$93.21	$62.78	5
North Carolina	511	$25.77	$18.42	20
Michigan	187	$80.68	$59.14	4
Colorado	149	$85.86	$67.97	2
Ohio	130	$85.77	$66.43	1
Iowa	76	$92.18	$58.84	1
Illinois	60	$78.12	$68.28	1
Idaho	53	$76.60	$59.15	1
Nevada	52	$82.78	$68.80	1
Minnesota	25	$92.60	$68.82	1
Tennessee	14	$26.02	$20.87	1

Related codes

76120Imaging of organ$59.18

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.