How much does Medicare pay for CPT 78608?

Medicare allowed an average of $679.50 per service and paid $539.29 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2498.19, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78608?

Nuclear medicine study of brain with metabolic evaluation. It was billed 11,958 times to 10,711 Medicare beneficiaries by 305 providers in 2024.

Does 78608 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1083.01 in an office setting and $68.47 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 78608 most?

Diagnostic Radiology, with 9,153 services from 210 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Neurology.

CPT 78608

Nuclear medicine study of brain with metabolic evaluation

$679.50Medicare-allowed amount per service, averaged across 11,958 services

Providers submitted

$2498.19

Asking price, not received

Medicare allowed

$679.50

The fee schedule figure

Medicare paid

$539.29

Balance is patient coinsurance

Providers submitted an average of $2498.19 for this code and Medicare allowed $679.50 — 3.7× 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 $539.29 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1083.01
Hospital / facility: $68.47

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. 7,202 services were billed in an office setting and 4,756 in a facility.

Services: 11,958
Beneficiaries: 10,711
Providers billing it: 305
Total allowed: $8,125,461

What Medicare pays for CPT 78608

Across 11,958 services billed by 305 providers to 10,711 beneficiaries, Medicare allowed an average of $679.50 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 78608

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	9,153	7,948	$626.22	210
Nuclear Medicine	2,184	2,146	$727.06	68
Independent Diagnostic Testing Facility (IDTF)	362	362	$1467.32	17
Neurology	126	122	$1467.21	3
Radiation Oncology	37	37	$66.46	1
Endocrinology	31	31	$869.59	1
Interventional Radiology	28	28	$885.10	2
Psychiatry	14	14	$1310.50	1
Undefined Physician type	12	12	$62.91	1
Internal Medicine	11	11	$1490.11	1

78608 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
New York	2,578	$855.25	$664.17	27
California	1,985	$1156.55	$902.65	46
Maryland	965	$845.97	$671.55	13
Minnesota	750	$123.21	$92.66	26
Florida	738	$911.96	$721.65	27
Texas	621	$553.62	$437.40	18
Arizona	567	$492.82	$385.14	13
Ohio	425	$220.20	$175.21	12
Massachusetts	331	$421.86	$335.79	16
Virginia	319	$573.17	$469.43	12
Illinois	268	$438.58	$340.77	9
Oregon	218	$69.84	$50.72	8
Rhode Island	212	$68.73	$45.08	4
Tennessee	184	$364.91	$289.71	4
Nevada	174	$1148.69	$909.97	6
Washington	159	$735.58	$578.89	6
New Jersey	152	$634.35	$506.28	7
Pennsylvania	126	$196.54	$154.55	5
Wisconsin	122	$1265.47	$973.91	6
Kansas	119	$65.13	$49.57	2
Michigan	116	$67.64	$47.22	5
New Hampshire	114	$255.91	$199.76	3
Arkansas	112	$68.66	$49.02	3
Iowa	78	$359.31	$279.94	2
Connecticut	68	$68.33	$49.82	4
Mississippi	65	$276.02	$214.01	3
Missouri	61	$65.48	$46.89	3
Georgia	52	$834.64	$659.34	1
Utah	45	$64.19	$48.73	2
Nebraska	41	$63.36	$48.19	2
Colorado	33	$64.28	$48.16	1
Indiana	32	$68.51	$48.15	2
North Carolina	31	$971.81	$768.13	1
West Virginia	20	$67.74	$48.63	1
Louisiana	17	$64.47	$51.36	1
District of Columbia	17	$71.45	$48.39	1
Montana	17	$65.21	$51.01	1
Kentucky	14	$67.99	$44.02	1
Vermont	12	$65.35	$51.34	1

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.