How much does Medicare pay for CPT 78492?

Medicare allowed an average of $1331.27 per service and paid $1056.74 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3387.93, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78492?

Nuclear medicine studies of blood flow in heart muscle at rest and with stress. It was billed 75,824 times to 75,528 Medicare beneficiaries by 721 providers in 2024.

Does 78492 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1443.91 in an office setting and $81.21 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 78492 most?

Cardiology, with 57,190 services from 504 clinicians. Next are Interventional Cardiology, Clinical Cardiac Electrophysiology, Internal Medicine.

CPT 78492

Nuclear medicine studies of blood flow in heart muscle at rest and with stress

$1331.27Medicare-allowed amount per service, averaged across 75,824 services

Providers submitted

$3387.93

Asking price, not received

Medicare allowed

$1331.27

The fee schedule figure

Medicare paid

$1056.74

Balance is patient coinsurance

Providers submitted an average of $3387.93 for this code and Medicare allowed $1331.27 — 2.5× 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 $1056.74 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1443.91
Hospital / facility: $81.21

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. 69,556 services were billed in an office setting and 6,268 in a facility.

Services: 75,824
Beneficiaries: 75,528
Providers billing it: 721
Total allowed: $100,942,216

What Medicare pays for CPT 78492

Across 75,824 services billed by 721 providers to 75,528 beneficiaries, Medicare allowed an average of $1331.27 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 78492

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	57,190	56,941	$1362.67	504
Interventional Cardiology	12,422	12,396	$1340.99	142
Clinical Cardiac Electrophysiology	1,761	1,754	$1623.43	25
Internal Medicine	1,595	1,590	$1147.53	21
Diagnostic Radiology	1,312	1,308	$84.48	15
Nuclear Medicine	662	659	$1033.74	2
Advanced Heart Failure and Transplant Cardiology	556	556	$1051.76	8
Cardiac Surgery	179	178	$1520.11	1
Interventional Radiology	147	146	$79.89	3

78492 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	23,038	$1448.38	$1149.07	110
Texas	10,298	$1207.65	$958.77	132
New York	4,526	$1523.40	$1215.18	29
Florida	4,382	$1445.43	$1142.42	48
Maryland	4,347	$1640.78	$1307.05	33
Arizona	3,344	$1231.99	$975.52	45
Georgia	3,269	$1354.06	$1050.01	46
Louisiana	3,234	$1308.81	$1055.54	33
New Jersey	3,004	$1623.64	$1295.82	30
Alabama	2,399	$517.94	$406.05	33
Nevada	2,385	$1221.22	$982.49	16
Illinois	2,248	$1261.64	$1000.30	23
Tennessee	1,220	$199.32	$155.11	38
Iowa	1,046	$1197.64	$958.73	8
North Carolina	954	$1554.52	$1255.51	1
Alaska	795	$1620.11	$1296.60	10
Oklahoma	705	$1368.54	$1073.34	3
Washington	596	$1287.94	$1033.85	7
Virginia	582	$1425.33	$1119.19	5
Mississippi	580	$1403.44	$1066.12	7
Wisconsin	483	$1260.31	$1003.68	10
Kentucky	460	$479.97	$379.77	11
Oregon	408	$1354.80	$1087.11	6
Ohio	361	$79.27	$60.73	8
Missouri	282	$1257.07	$967.78	7
Pennsylvania	267	$754.12	$585.64	7
Connecticut	239	$1369.06	$1115.96	4
Colorado	200	$82.25	$59.85	8
Michigan	102	$1664.48	$1316.88	1
District of Columbia	57	$82.68	$61.89	1
Utah	13	$82.69	$63.00	1

Related codes

78452Nuclear medicine studies of heart muscle at rest and$233.43
78431Nuclear medicine studies of blood flow in heart muscle at rest and$1606.23
78434Nuclear medicine study of heart muscle blood flow by pet$292.41
78451Nuclear medicine study of heart muscle at rest and$122.96
78454Nuclear medicine studies of heart muscle at rest and$61.60
78472Nuclear medicine study of heart pumping function by labeling red blood$123.30

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.