How much does Medicare pay for CPT 78315?

Medicare allowed an average of $99.43 per service and paid $77.14 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $410.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78315?

Nuclear medicine study of bone taken at different times. It was billed 14,238 times to 14,062 Medicare beneficiaries by 620 providers in 2024.

Does 78315 pay differently in an office than a hospital?

Yes. The allowed amount averaged $279.98 in an office setting and $46.01 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 78315 most?

Diagnostic Radiology, with 11,669 services from 536 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Interventional Radiology.

CPT 78315

Nuclear medicine study of bone taken at different times

$99.43Medicare-allowed amount per service, averaged across 14,238 services

Providers submitted

$410.76

Asking price, not received

Medicare allowed

$99.43

The fee schedule figure

Medicare paid

$77.14

Balance is patient coinsurance

Providers submitted an average of $410.76 for this code and Medicare allowed $99.43 — 4.1× 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 $77.14 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $279.98
Hospital / facility: $46.01

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. 3,251 services were billed in an office setting and 10,987 in a facility.

Services: 14,238
Beneficiaries: 14,062
Providers billing it: 620
Total allowed: $1,415,684

What Medicare pays for CPT 78315

Across 14,238 services billed by 620 providers to 14,062 beneficiaries, Medicare allowed an average of $99.43 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 78315

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	11,669	11,553	$90.49	536
Nuclear Medicine	2,175	2,153	$126.05	65
Independent Diagnostic Testing Facility (IDTF)	253	217	$252.21	9
Interventional Radiology	119	117	$152.93	8
Radiation Oncology	11	11	$44.61	1
Orthopedic Surgery	11	11	$283.15	1

78315 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
Florida	1,529	$171.68	$136.97	61
Texas	1,506	$92.15	$72.44	52
California	1,021	$130.61	$91.69	34
Pennsylvania	899	$66.22	$51.03	40
Illinois	573	$68.04	$50.14	24
Ohio	557	$59.84	$45.72	19
Michigan	507	$45.69	$35.08	22
Missouri	498	$51.41	$40.91	20
New York	495	$115.26	$81.17	24
North Carolina	494	$44.87	$35.20	22
Maryland	494	$241.70	$174.86	15
Virginia	396	$45.74	$35.59	17
Massachusetts	352	$79.46	$61.57	18
Tennessee	310	$92.64	$80.21	17
Arkansas	307	$43.33	$36.04	11
Colorado	296	$106.47	$80.61	10
Arizona	289	$212.28	$169.22	12
Washington	272	$126.07	$94.40	12
South Carolina	267	$44.53	$35.64	14
Oklahoma	226	$45.02	$35.44	12
Nevada	214	$226.72	$177.88	11
New Jersey	212	$126.30	$90.94	11
Alabama	209	$44.29	$35.82	11
Mississippi	205	$55.46	$46.04	12
Minnesota	184	$158.04	$118.65	12
Indiana	176	$62.89	$50.89	8
Delaware	169	$102.37	$81.71	7
Georgia	147	$46.28	$34.82	10
Kentucky	146	$86.52	$71.47	9
Utah	133	$44.62	$35.16	6
Wisconsin	125	$44.76	$35.36	7
South Dakota	100	$45.09	$34.16	5
Rhode Island	98	$46.51	$35.44	4
Nebraska	97	$43.54	$35.64	8
Idaho	84	$89.01	$74.49	5
New Hampshire	78	$46.26	$35.06	4
Oregon	75	$47.20	$35.02	4
Iowa	69	$44.28	$35.74	3
District of Columbia	65	$50.10	$34.20	4
Kansas	63	$168.11	$130.40	4
New Mexico	55	$46.89	$36.93	3
Louisiana	50	$43.55	$36.45	4
Connecticut	48	$302.23	$237.05	1
Puerto Rico	35	$302.85	$221.93	2
Alaska	29	$59.04	$31.99	2
Montana	23	$45.82	$35.31	2
West Virginia	23	$45.15	$35.34	2
Wyoming	14	$45.65	$34.38	1
North Dakota	13	$43.74	$37.76	1
AA	11	$46.21	$33.85	1

Related codes

78306Nuclear medicine study of bone and/or joint whole body$70.29

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.