How much does Medicare pay for CPT 78812?

Medicare allowed an average of $282.09 per service and paid $222.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1268.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78812?

Nuclear medicine study from skull base to mid-thigh. It was billed 5,374 times to 4,940 Medicare beneficiaries by 104 providers in 2024.

Does 78812 pay differently in an office than a hospital?

Yes. The allowed amount averaged $623.97 in an office setting and $87.86 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 78812 most?

Diagnostic Radiology, with 4,304 services from 83 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Interventional Radiology.

CPT 78812

Nuclear medicine study from skull base to mid-thigh

$282.09Medicare-allowed amount per service, averaged across 5,374 services

Providers submitted

$1268.56

Asking price, not received

Medicare allowed

$282.09

The fee schedule figure

Medicare paid

$222.86

Balance is patient coinsurance

Providers submitted an average of $1268.56 for this code and Medicare allowed $282.09 — 4.5× 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 $222.86 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $623.97
Hospital / facility: $87.86

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. 1,947 services were billed in an office setting and 3,427 in a facility.

Services: 5,374
Beneficiaries: 4,940
Providers billing it: 104
Total allowed: $1,515,952

What Medicare pays for CPT 78812

Across 5,374 services billed by 104 providers to 4,940 beneficiaries, Medicare allowed an average of $282.09 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 78812

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	4,304	3,951	$260.04	83
Nuclear Medicine	887	822	$170.74	15
Independent Diagnostic Testing Facility (IDTF)	155	139	$1459.03	4
Interventional Radiology	16	16	$85.09	1
Radiation Oncology	12	12	$1482.61	1

78812 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
Georgia	1,347	$88.86	$64.34	15
California	1,206	$575.10	$445.03	12
Michigan	643	$84.42	$64.00	9
Washington	418	$96.43	$64.75	8
Pennsylvania	399	$426.83	$332.08	9
North Carolina	346	$81.67	$63.68	6
New York	301	$424.56	$321.00	6
Minnesota	262	$87.32	$63.71	17
Arizona	128	$85.45	$64.53	5
Florida	85	$1073.93	$851.99	6
Maryland	50	$313.07	$244.26	2
Hawaii	49	$1676.99	$1336.16	1
Louisiana	39	$81.09	$62.52	1
Tennessee	26	$1296.94	$1028.30	2
Massachusetts	24	$83.81	$60.86	1
Missouri	16	$85.36	$62.19	1
Texas	13	$83.67	$66.29	1
Indiana	11	$83.22	$60.22	1
Wisconsin	11	$1505.84	$1199.78	1

Related codes

78815Nuclear medicine study from skull base to mid-thigh$611.91
78816Nuclear medicine study whole body$568.60
78803Nuclear medicine study$136.74
78814Nuclear medicine study limited area$1034.63
78830Nuclear medicine study$126.84
78832Nuclear medicine study$338.43
78835Quantification of radioactive materials$82.32
78800Nuclear medicine study$79.10
78802Nuclear medicine study$114.52
78813Nuclear medicine study whole body$400.76
78811Nuclear medicine study limited area$856.12

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.