How much does Medicare pay for CPT 78830?

Medicare allowed an average of $126.84 per service and paid $98.54 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $685.64, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78830?

Nuclear medicine study, spect imaging with concurrent ct scan, 1 area or single acquisition, single day imaging. It was billed 28,808 times to 27,610 Medicare beneficiaries by 764 providers in 2024.

Does 78830 pay differently in an office than a hospital?

Yes. The allowed amount averaged $335.84 in an office setting and $66.25 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 78830 most?

Diagnostic Radiology, with 17,891 services from 504 clinicians. Next are Nuclear Medicine, Cardiology, Interventional Radiology.

CPT 78830

Nuclear medicine study, spect imaging with concurrent ct scan, 1 area or single acquisition, single day imaging

$126.84Medicare-allowed amount per service, averaged across 28,808 services

Providers submitted

$685.64

Asking price, not received

Medicare allowed

$126.84

The fee schedule figure

Medicare paid

$98.54

Balance is patient coinsurance

Providers submitted an average of $685.64 for this code and Medicare allowed $126.84 — 5.4× 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 $98.54 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $335.84
Hospital / facility: $66.25

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. 6,474 services were billed in an office setting and 22,334 in a facility.

Services: 28,808
Beneficiaries: 27,610
Providers billing it: 764
Total allowed: $3,654,007

What Medicare pays for CPT 78830

Across 28,808 services billed by 764 providers to 27,610 beneficiaries, Medicare allowed an average of $126.84 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 78830

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	17,891	17,028	$138.81	504
Nuclear Medicine	9,457	9,169	$108.84	202
Cardiology	981	980	$80.88	36
Interventional Radiology	214	171	$92.71	11
Radiation Oncology	70	70	$62.27	2
Internal Medicine	69	69	$72.17	3
Family Practice	46	46	$358.55	2
Interventional Cardiology	43	40	$65.24	2
Emergency Medicine	37	37	$362.49	2

78830 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	4,115	$226.49	$160.20	68
Pennsylvania	2,316	$67.69	$50.94	63
New York	1,990	$87.63	$61.76	41
Florida	1,944	$190.88	$154.20	50
Texas	1,694	$187.35	$145.89	36
Ohio	1,483	$63.95	$49.89	30
Oregon	1,352	$166.68	$132.24	32
Michigan	1,206	$70.73	$52.43	39
Virginia	1,089	$139.12	$99.87	26
Illinois	1,069	$72.50	$55.24	39
Massachusetts	1,033	$112.82	$81.12	29
Arizona	808	$246.99	$197.47	21
Washington	743	$176.18	$129.78	22
Wisconsin	731	$62.73	$50.00	28
Missouri	583	$64.35	$50.24	20
Colorado	527	$89.03	$67.49	16
Maryland	506	$151.46	$108.57	16
North Carolina	482	$117.98	$86.59	18
Utah	433	$62.66	$49.55	12
Georgia	426	$65.29	$49.89	16
Minnesota	375	$65.95	$49.06	16
Iowa	367	$63.07	$49.04	9
New Jersey	354	$70.29	$50.36	10
Arkansas	351	$65.40	$49.78	8
Kentucky	312	$65.29	$49.92	6
Connecticut	270	$86.28	$63.57	8
Vermont	228	$63.25	$48.66	4
Indiana	220	$63.77	$49.67	13
South Dakota	196	$63.68	$50.79	4
Alabama	183	$63.32	$50.03	7
Kansas	178	$63.20	$49.71	3
Louisiana	153	$62.99	$49.99	6
South Carolina	149	$62.78	$50.23	5
District of Columbia	141	$69.93	$51.21	4
West Virginia	128	$65.08	$50.13	3
Tennessee	119	$62.93	$49.91	7
Montana	97	$64.58	$50.62	5
Oklahoma	81	$63.52	$50.35	3
Maine	74	$67.14	$48.81	5
New Mexico	66	$280.66	$229.88	3
Idaho	63	$62.02	$49.56	2
Hawaii	31	$64.30	$50.23	1
Mississippi	30	$65.28	$49.92	2
Nebraska	28	$62.14	$44.49	2
Nevada	18	$65.09	$45.85	1
Rhode Island	16	$66.13	$51.51	1
Delaware	14	$64.70	$51.37	1
Wyoming	13	$63.32	$47.60	1
Puerto Rico	12	$427.56	$337.79	1
North Dakota	11	$63.93	$42.29	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
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.