How much does Medicare pay for CPT 82365?

Medicare allowed an average of $12.63 per service and paid $12.63 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $98.00, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82365?

Infrared analysis of stone. It was billed 24,450 times to 23,009 Medicare beneficiaries by 79 providers in 2024.

Does 82365 pay differently in an office than a hospital?

Yes. The allowed amount averaged $12.63 in an office setting and $12.64 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 82365 most?

Clinical Laboratory, with 24,411 services from 76 clinicians. Next are Pathology.

CPT 82365

Infrared analysis of stone

$12.63Medicare-allowed amount per service, averaged across 24,450 services

Providers submitted

$98.00

Asking price, not received

Medicare allowed

$12.63

The fee schedule figure

Medicare paid

$12.63

Balance is patient coinsurance

Providers submitted an average of $98.00 for this code and Medicare allowed $12.63 — 7.8× 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 $12.63 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $12.63
Hospital / facility: $12.64

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 24,424 services were billed in an office setting and 26 in a facility.

Services: 24,450
Beneficiaries: 23,009
Providers billing it: 79
Total allowed: $308,804

What Medicare pays for CPT 82365

Across 24,450 services billed by 79 providers to 23,009 beneficiaries, Medicare allowed an average of $12.63 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 82365

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	24,411	22,973	$12.63	76
Pathology	39	36	$12.64	3

82365 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
Illinois	11,018	$12.64	$12.64	2
New Jersey	2,143	$12.63	$12.64	2
Florida	1,711	$12.64	$12.64	7
California	1,684	$12.63	$12.64	8
Tennessee	1,154	$12.60	$12.64	2
Texas	1,070	$12.63	$12.64	5
Georgia	644	$12.64	$12.64	1
Arizona	633	$12.59	$12.64	2
New York	622	$12.64	$12.64	4
Kansas	409	$12.64	$12.64	1
Minnesota	344	$12.64	$12.64	5
Wisconsin	321	$12.57	$12.64	2
Utah	297	$12.60	$12.64	2
Pennsylvania	288	$12.60	$12.64	4
Massachusetts	265	$12.64	$12.64	2
Virginia	242	$12.64	$12.64	4
Oregon	228	$12.51	$12.64	1
Ohio	227	$12.54	$12.64	5
Oklahoma	213	$12.63	$12.64	4
Indiana	163	$12.64	$12.64	2
Colorado	159	$12.64	$12.64	2
Nevada	128	$12.64	$12.64	1
Maryland	114	$12.64	$12.64	3
Kentucky	95	$12.42	$12.64	1
Washington	80	$12.64	$12.64	1
Hawaii	79	$12.64	$12.64	2
Alabama	50	$12.23	$12.64	1
New Mexico	40	$12.64	$12.64	1
South Carolina	17	$12.64	$12.64	1
Connecticut	12	$12.64	$12.64	1

Related codes

82306Vitamin d-3 level$28.96
82310Calcium level$5.02
82378Carcinoembryonic antigen (cea) protein level$18.54
82330Calcium level$13.39
82340Urine calcium level$5.91
82374Carbon dioxide (bicarbonate) level$4.67
82390Ceruloplasmin (protein) level$10.52
82397Analysis using chemiluminescent technique (light and chemical )reactio$13.82
82384Catecholamines (organic nitrogen) level$24.65
82300Cadmium level$23.10
82308Calcitonin (hormone) level$26.16
82375Carboxyhemoglobin (protein) level$12.02

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.