How much does Medicare pay for CPT 76380?

Medicare allowed an average of $55.39 per service and paid $43.14 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $323.51, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 76380?

Limited or follow-up ct scan. It was billed 4,098 times to 3,751 Medicare beneficiaries by 170 providers in 2024.

Does 76380 pay differently in an office than a hospital?

Yes. The allowed amount averaged $99.09 in an office setting and $44.95 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 76380 most?

Diagnostic Radiology, with 2,560 services from 97 clinicians. Next are Interventional Radiology, Pulmonary Disease, Otolaryngology.

CPT 76380

Limited or follow-up ct scan

$55.39Medicare-allowed amount per service, averaged across 4,098 services

Providers submitted

$323.51

Asking price, not received

Medicare allowed

$55.39

The fee schedule figure

Medicare paid

$43.14

Balance is patient coinsurance

Providers submitted an average of $323.51 for this code and Medicare allowed $55.39 — 5.8× 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 $43.14 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $99.09
Hospital / facility: $44.95

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. 790 services were billed in an office setting and 3,308 in a facility.

Services: 4,098
Beneficiaries: 3,751
Providers billing it: 170
Total allowed: $226,988

What Medicare pays for CPT 76380

Across 4,098 services billed by 170 providers to 3,751 beneficiaries, Medicare allowed an average of $55.39 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 76380

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	2,560	2,375	$52.17	97
Interventional Radiology	1,023	894	$52.54	53
Pulmonary Disease	235	227	$44.43	7
Otolaryngology	218	197	$122.18	9
Neurosurgery	31	29	$44.72	2
Nurse Practitioner	17	17	$35.68	1
Neurology	14	12	$44.54	1

76380 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	686	$50.09	$33.24	19
Florida	456	$56.61	$42.20	19
Illinois	409	$56.92	$41.70	19
New Hampshire	295	$43.73	$32.77	11
Texas	281	$49.20	$37.23	11
Pennsylvania	279	$46.18	$33.08	8
Tennessee	227	$85.29	$71.27	10
Nebraska	215	$97.18	$78.29	10
Michigan	138	$42.87	$33.18	8
Massachusetts	135	$46.24	$33.03	7
New York	109	$81.17	$56.11	6
Louisiana	107	$42.57	$33.78	3
Missouri	80	$43.33	$32.72	4
Ohio	64	$43.10	$32.04	3
North Carolina	62	$55.79	$42.73	4
Colorado	60	$45.53	$33.61	2
Kansas	45	$41.92	$32.79	2
Connecticut	43	$44.77	$33.63	2
Minnesota	40	$43.37	$33.58	1
Wyoming	36	$129.41	$93.74	1
Iowa	30	$81.04	$67.83	2
South Dakota	30	$42.42	$33.50	1
Vermont	30	$43.87	$32.45	1
Indiana	28	$42.35	$33.66	2
Wisconsin	27	$41.99	$33.56	2
South Carolina	24	$43.89	$33.53	2
Delaware	22	$45.15	$30.77	1
North Dakota	21	$41.91	$34.03	1
Georgia	21	$43.86	$33.45	1
District of Columbia	19	$47.73	$33.53	1
Maryland	16	$42.12	$34.53	1
Washington	15	$43.79	$33.55	1
Oregon	14	$44.54	$33.54	1
Arkansas	12	$41.42	$33.66	1
Virginia	11	$42.73	$33.62	1
Alaska	11	$43.37	$33.66	1

Related codes

763763d radiographic procedure$12.62
763773d radiographic procedure$50.10
76391Mri and low frequency vibrations for measuring tissue stiffness$112.99

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.