How much does Medicare pay for CPT 78815?

Medicare allowed an average of $611.91 per service and paid $484.38 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2120.60, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78815?

Nuclear medicine study from skull base to mid-thigh with ct scan. It was billed 816,970 times to 737,087 Medicare beneficiaries by 6,683 providers in 2024.

Does 78815 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1108.94 in an office setting and $109.94 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 78815 most?

Diagnostic Radiology, with 572,560 services from 5,067 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Hematology-Oncology.

CPT 78815

Nuclear medicine study from skull base to mid-thigh with ct scan

$611.91Medicare-allowed amount per service, averaged across 816,970 services

Providers submitted

$2120.60

Asking price, not received

Medicare allowed

$611.91

The fee schedule figure

Medicare paid

$484.38

Balance is patient coinsurance

Providers submitted an average of $2120.60 for this code and Medicare allowed $611.91 — 3.5× 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 $484.38 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1108.94
Hospital / facility: $109.94

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. 410,509 services were billed in an office setting and 406,461 in a facility.

Services: 816,970
Beneficiaries: 737,087
Providers billing it: 6,683
Total allowed: $499,912,113

What Medicare pays for CPT 78815

Across 816,970 services billed by 6,683 providers to 737,087 beneficiaries, Medicare allowed an average of $611.91 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 78815

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	572,560	526,339	$467.37	5,067
Nuclear Medicine	126,567	115,502	$557.24	375
Independent Diagnostic Testing Facility (IDTF)	40,365	31,843	$1518.95	146
Hematology-Oncology	35,440	28,335	$1463.12	483
Radiation Oncology	13,832	11,110	$1370.77	141
Medical Oncology	11,389	8,663	$1429.81	189
Interventional Radiology	9,416	8,703	$477.38	104
Urology	2,335	2,276	$1287.53	69
Internal Medicine	1,773	1,432	$1273.07	32
Gynecological Oncology	680	541	$1467.59	23
Undefined Physician type	441	422	$1004.70	3
Hematology	427	316	$1739.85	7
Pediatric Medicine	426	392	$1327.47	1
Family Practice	279	263	$618.72	6
Emergency Medicine	188	176	$646.59	4

78815 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	92,774	$915.28	$717.33	625
Texas	68,680	$577.26	$458.88	608
Florida	65,200	$915.15	$721.26	364
New York	58,828	$845.02	$661.45	353
Illinois	33,795	$447.90	$352.58	350
Pennsylvania	31,287	$468.02	$366.88	243
Massachusetts	28,733	$721.10	$570.05	156
Maryland	25,027	$1010.17	$804.11	107
North Carolina	22,897	$288.60	$225.99	196
Virginia	21,264	$539.63	$433.56	148
New Jersey	20,680	$865.22	$681.22	169
Minnesota	20,617	$355.51	$272.54	181
Arizona	19,070	$908.96	$721.83	170
Ohio	18,879	$248.13	$191.68	178
Georgia	18,857	$215.70	$165.77	191
Missouri	18,600	$199.55	$155.58	164
Tennessee	17,935	$463.54	$367.43	156
Arkansas	15,626	$708.88	$564.75	90
Colorado	15,234	$641.04	$508.69	118
Michigan	15,000	$154.51	$115.81	143
Washington	14,835	$559.70	$440.75	120
Indiana	14,177	$395.99	$312.39	144
South Carolina	13,646	$317.40	$246.16	117
Oklahoma	11,602	$340.86	$267.50	91
Alabama	11,501	$801.58	$639.05	140
Wisconsin	10,900	$343.24	$269.93	174
Kansas	10,460	$504.83	$400.40	97
Kentucky	9,547	$251.34	$197.35	97
Louisiana	9,111	$413.51	$327.59	111
Iowa	7,494	$415.80	$324.43	90
Mississippi	7,347	$257.59	$202.22	74
Oregon	7,062	$469.71	$377.82	76
Nevada	6,344	$1197.92	$954.52	72
Connecticut	5,944	$301.12	$232.26	67
Nebraska	5,164	$455.51	$361.81	63
West Virginia	4,507	$106.56	$79.50	70
Idaho	3,763	$497.63	$391.87	42
New Hampshire	3,474	$273.50	$212.45	52
Maine	3,358	$387.70	$301.09	40
North Dakota	3,272	$332.30	$247.58	30
Rhode Island	3,016	$351.96	$274.20	17
New Mexico	2,979	$769.68	$606.51	27
Utah	2,658	$379.56	$303.47	39
Delaware	2,251	$285.89	$220.36	13
Alaska	2,241	$1165.49	$917.91	14
Wyoming	2,120	$611.27	$461.29	16
South Dakota	2,002	$624.79	$479.38	16
Hawaii	1,874	$875.23	$708.16	5
Vermont	1,764	$220.09	$169.64	14
Montana	1,737	$171.73	$131.22	28
District of Columbia	1,199	$125.45	$87.99	7
Puerto Rico	280	$1148.34	$898.17	7
XX	192	$1394.83	$1107.22	1
AP	94	$109.05	$79.28	1
AA	72	$107.90	$83.02	1

Related codes

78816Nuclear medicine study whole body$568.60
78803Nuclear medicine study$136.74
78814Nuclear medicine study limited area$1034.63
78830Nuclear medicine study$126.84
78812Nuclear medicine study from skull base to mid-thigh$282.09
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.