How much does Medicare pay for CPT 82378?

Medicare allowed an average of $18.54 per service and paid $18.54 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $97.87, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82378?

Carcinoembryonic antigen (cea) protein level. It was billed 444,322 times to 220,006 Medicare beneficiaries by 1,542 providers in 2024.

Which specialty bills 82378 most?

Clinical Laboratory, with 255,240 services from 280 clinicians. Next are Hematology-Oncology, Pathology, Medical Oncology.

CPT 82378

Carcinoembryonic antigen (cea) protein level

$18.54Medicare-allowed amount per service, averaged across 444,322 services

Providers submitted

$97.87

Asking price, not received

Medicare allowed

$18.54

The fee schedule figure

Medicare paid

$18.54

Balance is patient coinsurance

Providers submitted an average of $97.87 for this code and Medicare allowed $18.54 — 5.3× 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 $18.54 (100%); the rest is the patient’s coinsurance and deductible.

Services: 444,322
Beneficiaries: 220,006
Providers billing it: 1,542
Total allowed: $8,237,730

What Medicare pays for CPT 82378

Across 444,322 services billed by 1,542 providers to 220,006 beneficiaries, Medicare allowed an average of $18.54 per service. That is 2.0 services per beneficiary, so this is a code patients typically receive more than once. 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 82378

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	255,240	137,172	$18.55	280
Hematology-Oncology	97,170	41,199	$18.50	762
Pathology	46,251	19,631	$18.55	12
Medical Oncology	27,338	11,951	$18.50	233
Nurse Practitioner	5,616	3,621	$18.51	119
Internal Medicine	4,897	2,544	$18.50	52
Hematology	4,313	1,556	$18.52	19
Physician Assistant	1,671	971	$18.48	31
Cardiology	409	281	$18.42	3
Hospitalist	334	251	$18.58	2
Obstetrics & Gynecology	209	203	$18.58	3
Gastroenterology	172	79	$18.58	5
Radiation Oncology	149	98	$18.58	3
Family Practice	148	135	$18.58	3
General Surgery	110	94	$18.58	4

82378 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	82,940	$18.57	$18.58	116
Florida	69,526	$18.56	$18.58	75
New Jersey	48,777	$18.56	$18.58	30
Texas	41,318	$18.53	$18.58	249
New York	38,077	$18.54	$18.58	146
Arizona	15,181	$18.53	$18.58	5
North Carolina	12,213	$18.54	$18.58	26
Arkansas	10,608	$18.46	$18.58	38
Illinois	9,622	$18.53	$18.58	84
Nevada	9,230	$18.47	$18.58	46
Tennessee	9,216	$18.48	$18.58	81
Maryland	8,509	$18.56	$18.58	45
Colorado	7,599	$18.54	$18.58	32
Ohio	7,137	$18.54	$18.58	27
Virginia	6,763	$18.49	$18.58	88
Pennsylvania	6,759	$18.56	$18.58	27
Kansas	6,709	$18.57	$18.58	17
Washington	6,421	$18.55	$18.57	21
Alabama	6,171	$18.50	$18.58	45
Georgia	4,610	$18.51	$18.58	32
Mississippi	3,515	$18.28	$18.58	17
Massachusetts	3,349	$18.57	$18.58	7
Minnesota	3,208	$18.54	$18.58	28
South Carolina	3,017	$18.42	$18.58	36
Hawaii	2,884	$18.52	$18.58	5
Wisconsin	2,873	$18.28	$18.58	6
Indiana	2,142	$18.35	$18.58	24
Nebraska	1,949	$18.55	$18.56	22
New Mexico	1,907	$18.54	$18.56	7
Michigan	1,829	$18.45	$18.58	16
Iowa	1,677	$18.45	$18.58	31
Oregon	1,615	$18.44	$18.58	25
Oklahoma	1,583	$18.54	$18.58	10
Utah	1,025	$18.51	$18.58	17
Louisiana	1,000	$18.56	$18.58	5
Puerto Rico	767	$18.46	$18.58	16
Wyoming	383	$18.56	$18.58	4
Connecticut	378	$18.50	$18.58	5
Kentucky	361	$18.54	$18.58	7
Missouri	343	$18.50	$18.58	6
South Dakota	298	$18.58	$18.58	2
Maine	250	$18.24	$18.58	5
Rhode Island	152	$18.48	$18.58	1
Alaska	110	$18.58	$18.58	1
North Dakota	107	$18.34	$18.58	2
Idaho	69	$18.58	$18.58	2
West Virginia	66	$18.58	$18.58	3
Delaware	66	$18.58	$18.58	1
U.S. Virgin Islands	13	$18.58	$18.58	1

Related codes

82306Vitamin d-3 level$28.96
82310Calcium level$5.02
82330Calcium level$13.39
82340Urine calcium level$5.91
82374Carbon dioxide (bicarbonate) level$4.67
82390Ceruloplasmin (protein) level$10.52
82365Infrared analysis of stone$12.63
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.