How much does Medicare pay for CPT 78709?

Medicare allowed an average of $119.04 per service and paid $93.09 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $566.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78709?

Nuclear medicine studies of kidney, blood flow, and function. It was billed 1,226 times to 1,192 Medicare beneficiaries by 60 providers in 2024.

Does 78709 pay differently in an office than a hospital?

Yes. The allowed amount averaged $262.45 in an office setting and $63.33 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 78709 most?

Diagnostic Radiology, with 907 services from 45 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Internal Medicine.

CPT 78709

Nuclear medicine studies of kidney, blood flow, and function

$119.04Medicare-allowed amount per service, averaged across 1,226 services

Providers submitted

$566.72

Asking price, not received

Medicare allowed

$119.04

The fee schedule figure

Medicare paid

$93.09

Balance is patient coinsurance

Providers submitted an average of $566.72 for this code and Medicare allowed $119.04 — 4.8× 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 $93.09 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $262.45
Hospital / facility: $63.33

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. 343 services were billed in an office setting and 883 in a facility.

Services: 1,226
Beneficiaries: 1,192
Providers billing it: 60
Total allowed: $145,943

What Medicare pays for CPT 78709

Across 1,226 services billed by 60 providers to 1,192 beneficiaries, Medicare allowed an average of $119.04 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 78709

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	907	887	$102.70	45
Nuclear Medicine	230	224	$107.06	10
Independent Diagnostic Testing Facility (IDTF)	35	33	$330.05	2
Internal Medicine	30	25	$299.93	1
Urology	24	23	$317.47	2

78709 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
Texas	208	$108.24	$85.33	8
Florida	145	$152.02	$121.74	9
California	137	$137.34	$96.48	6
New York	94	$63.78	$47.44	6
Georgia	76	$64.14	$49.23	3
Washington	75	$67.34	$46.61	2
Massachusetts	73	$311.12	$243.45	2
North Carolina	64	$62.05	$46.40	3
Illinois	63	$63.54	$48.47	4
Arizona	63	$290.65	$247.81	3
Michigan	57	$62.93	$48.88	3
Ohio	34	$60.09	$46.09	2
Virginia	32	$62.56	$50.47	2
Arkansas	31	$59.82	$46.99	2
New Jersey	29	$178.93	$129.04	2
District of Columbia	19	$68.44	$49.94	1
Alabama	13	$63.88	$49.79	1
Indiana	13	$64.85	$49.98	1

Related codes

78708Nuclear medicine study of kidney$75.26

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.