How much does Medicare pay for HCPCS G0279?

Medicare allowed an average of $33.24 per service and paid $24.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $153.50, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0279?

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066). It was billed 978,420 times to 936,552 Medicare beneficiaries by 9,177 providers in 2024.

Does G0279 pay differently in an office than a hospital?

Yes. The allowed amount averaged $39.27 in an office setting and $27.72 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 G0279 most?

Diagnostic Radiology, with 931,596 services from 8,601 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, General Surgery.

HCPCS G0279

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

$33.24Medicare-allowed amount per service, averaged across 978,420 services

Providers submitted

$153.50

Asking price, not received

Medicare allowed

$33.24

The fee schedule figure

Medicare paid

$24.28

Balance is patient coinsurance

Providers submitted an average of $153.50 for this code and Medicare allowed $33.24 — 4.6× 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 $24.28 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $39.27
Hospital / facility: $27.72

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. 467,963 services were billed in an office setting and 510,457 in a facility.

Services: 978,420
Beneficiaries: 936,552
Providers billing it: 9,177
Total allowed: $32,522,681

What Medicare pays for HCPCS G0279

Across 978,420 services billed by 9,177 providers to 936,552 beneficiaries, Medicare allowed an average of $33.24 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 G0279

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	931,596	893,322	$33.18	8,601
Independent Diagnostic Testing Facility (IDTF)	18,779	17,282	$36.10	159
Interventional Radiology	7,448	7,297	$34.12	95
General Surgery	6,062	5,611	$35.28	33
Obstetrics & Gynecology	3,664	3,105	$29.96	114
Family Practice	1,841	1,593	$25.86	52
Internal Medicine	1,705	1,590	$25.46	56
Surgical Oncology	1,632	1,400	$48.52	3
Radiation Oncology	997	903	$35.64	8
Nurse Practitioner	725	718	$38.83	8
Nuclear Medicine	692	687	$37.32	7
Mammography Center	688	614	$39.60	2
Hematology-Oncology	574	521	$44.98	13
Rheumatology	483	450	$17.18	1
Emergency Medicine	468	460	$24.05	9

G0279 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	94,521	$37.41	$25.06	751
Florida	84,502	$37.43	$27.84	586
New York	60,276	$37.06	$25.26	583
Texas	56,594	$31.91	$23.44	532
Pennsylvania	48,261	$29.31	$21.02	428
Illinois	46,647	$30.15	$21.32	418
North Carolina	37,828	$33.57	$25.01	359
Virginia	34,943	$32.10	$23.08	246
New Jersey	34,609	$40.29	$27.99	310
Massachusetts	33,034	$30.51	$20.89	299
Maryland	29,116	$40.78	$28.53	161
Ohio	28,257	$27.98	$20.33	313
Georgia	27,487	$30.97	$22.74	290
Tennessee	25,089	$30.98	$23.21	268
Washington	22,209	$34.53	$23.81	169
Arizona	22,128	$36.95	$27.77	139
Missouri	21,376	$28.01	$20.67	213
Michigan	21,106	$29.41	$20.80	252
Indiana	20,150	$28.26	$20.61	164
South Carolina	15,785	$29.13	$21.76	130
Minnesota	15,626	$33.50	$24.49	219
Wisconsin	14,202	$29.75	$22.10	237
Colorado	13,165	$36.98	$25.75	132
Arkansas	13,107	$31.32	$23.97	83
Kentucky	11,370	$29.00	$21.58	113
Louisiana	10,927	$28.12	$21.06	146
Oklahoma	10,925	$28.11	$20.97	88
Oregon	9,971	$28.09	$20.45	125
Connecticut	9,925	$33.87	$23.85	154
Iowa	9,671	$29.48	$22.25	117
Alabama	9,627	$29.87	$22.92	150
District of Columbia	9,452	$36.97	$25.36	45
Kansas	8,949	$29.60	$22.56	104
Mississippi	7,384	$27.94	$21.80	94
Rhode Island	6,055	$34.99	$24.67	40
Nebraska	5,754	$29.43	$22.49	82
New Mexico	5,651	$36.67	$28.06	52
Nevada	5,624	$39.09	$29.28	64
Delaware	4,479	$34.69	$24.77	32
New Hampshire	4,225	$30.55	$22.01	55
Maine	3,523	$27.82	$18.69	54
Utah	3,213	$28.97	$20.85	58
West Virginia	2,984	$27.27	$19.05	59
Idaho	2,967	$28.34	$20.99	44
South Dakota	2,808	$29.35	$20.74	38
Hawaii	2,717	$37.10	$25.90	33
North Dakota	2,631	$25.80	$18.75	37
Montana	2,160	$30.16	$21.51	31
Vermont	1,767	$27.27	$19.81	25
Wyoming	1,475	$35.72	$26.97	25
Alaska	1,381	$26.24	$15.77	16
Puerto Rico	356	$41.75	$32.41	10
AP	299	$38.91	$26.33	2
Guam	110	$48.83	$30.85	1
AA	22	$27.55	$21.89	1

Related codes

G0283Electrical stimulation (unattended)$8.75
G0249Provision of test materials and equipment for home inr monitoring of p$87.99
G0268Removal of impacted cerumen (one or both ears) by physician on same da$49.73
G0277Hyperbaric oxygen under pressure$182.01
G0260Injection procedure for sacroiliac joint; provision of anesthetic$292.85
G0238Therapeutic procedures to improve respiratory function$10.50
G0270Medical nutrition therapy; reassessment and subsequent intervention(s)$26.66
G0250Physician review$8.26
G0296Counseling visit to discuss need for lung cancer screening$24.73
G0237Therapeutic procedures to increase strength or endurance of respirator$12.17
G0239Therapeutic procedures to improve respiratory function or increase str$13.67
G0247Routine foot care by a physician of a diabetic patient$67.85

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.