RxDoctor Payments Data

CPT 84478

Triglycerides level

$5.62Medicare-allowed amount per service, averaged across 76,422 services
Providers submitted
$30.15

Asking price, not received

Medicare allowed
$5.62

The fee schedule figure

Medicare paid
$5.62

Balance is patient coinsurance

Providers submitted an average of $30.15 for this code and Medicare allowed $5.625.4× 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 $5.62 (100%); the rest is the patient’s coinsurance and deductible.

Services
76,422

Medicare Part B, 2024

Beneficiaries
49,507
Providers billing it
313
Total allowed
$429,492

Services × allowed amount

What Medicare pays for CPT 84478

Across 76,422 services billed by 313 providers to 49,507 beneficiaries, Medicare allowed an average of $5.62 per service. That is 1.5 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 84478

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory56,43136,742$5.62173
Internal Medicine8,6304,755$5.6239
Family Practice8,4466,161$5.6267
Nurse Practitioner758540$5.6112
Pathology679270$5.625
Endocrinology473357$5.635
Gastroenterology271115$5.631
Geriatric Medicine262192$5.621
Allergy/ Immunology203146$5.631
Rheumatology5836$5.631
Emergency Medicine5142$5.631
Cardiology4242$5.631
Hematology-Oncology3333$5.482
General Practice2925$5.631
Pulmonary Disease2520$5.631

84478 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.

StateServicesAllowedStandardized pmtProviders
California15,847$5.62$5.6335
New Jersey8,587$5.61$5.619
New York6,782$5.63$5.6322
Texas6,356$5.63$5.6313
North Carolina5,025$5.62$5.639
Florida4,539$5.60$5.6026
South Carolina2,481$5.62$5.6310
Arizona2,469$5.54$5.555
Iowa2,247$5.62$5.6311
Ohio2,098$5.61$5.6225
Kansas2,058$5.63$5.6314
Pennsylvania1,875$5.63$5.6315
Mississippi1,842$5.62$5.634
Missouri1,702$5.61$5.6421
Indiana1,647$5.61$5.639
Illinois1,324$5.62$5.637
Massachusetts1,192$5.63$5.634
Alabama1,187$5.62$5.627
Oklahoma1,075$5.62$5.634
Arkansas1,062$5.62$5.634
Georgia959$5.62$5.632
Virginia648$5.62$5.6311
Tennessee642$5.63$5.636
Michigan427$5.63$5.636
Washington392$5.63$5.632
Nevada378$5.63$5.633
Colorado254$5.62$5.622
Maryland218$5.63$5.634
Hawaii205$5.62$5.632
Minnesota164$5.55$5.634
Wisconsin143$5.59$5.632
Oregon130$5.63$5.632
Nebraska128$5.63$5.633
Kentucky103$5.58$5.632
South Dakota93$5.63$5.633
Rhode Island54$5.63$5.631
U.S. Virgin Islands28$5.63$5.631
Utah26$5.63$5.631
Louisiana22$5.63$5.631
Puerto Rico13$5.33$5.331

Related codes

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.