HCPCS 78431

Imaging service (ClaimLight category; the code descriptor is not shown)

Imaging Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

459
79th percentile among 6,116 codes billed · 2020
$23M
93rd percentile among 6,116 codes billed · 2020
33K
77th percentile among 6,116 codes billed · 2020
40
70th percentile among 6,116 codes billed · 2020
233
72nd percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M$200M2020: $23M paid20202021: $55M paid20212022: $100M paid20222023: $163M paid20232024: $248M paid2024$248M$0$100M$200M2020: $23M paid20202021: $55M paid20212022: $100M paid20222023: $163M paid20232024: $248M paid2024$248M$0$100M$200M2020: $23M paid20202021: $55M paid20212022: $100M paid20222023: $163M paid20232024: $248M paid2024$248M$0$100M$200M2020: $23M paid20202021: $55M paid20212022: $100M paid20222023: $163M paid20232024: $248M paid2024$248M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

01,0002,0002020: 459 providers20202021: 691 providers20212022: 1,016 providers20222023: 1,377 providers20232024: 1,960 providers20241,96001,0002,0002020: 459 providers20202021: 691 providers20212022: 1,016 providers20222023: 1,377 providers20232024: 1,960 providers20241,96001,0002,0002020: 459 providers20202021: 691 providers20212022: 1,016 providers20222023: 1,377 providers20232024: 1,960 providers20241,96001,0002,0002020: 459 providers20202021: 691 providers20212022: 1,016 providers20222023: 1,377 providers20232024: 1,960 providers20241,960

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20241,960$248,249,716+52%193,996562960.00
20231,377$163,490,280+63%135,139513090.00
20221,016$100,087,015+83%96,781432950.00
2021691$54,665,436+138%59,524442660.00
2020459$22,930,880first year in data32,630402330.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Texas29$5,609,2233,47771315
Florida35$5,567,8993,08545313
Alabama37$4,380,8692,19637198
Mississippi17$1,777,5951,36823268
New York30$1,370,2343,60551359
Pennsylvania18$1,366,8431,16258111
Utah29$333,8233,15797225
Missouri21$252,7733,556106494
Illinois12$142,50969747103
California11$112,8935374983
Ohio23$91,4851,2184699
Michigan12$74,0671,02235268
Georgia17$72,3413571934
Oklahoma13$43,8114813468
Virginia13$42,92059538120

Not listed: 25 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2020.

Top metro areas

observed calculated calculated calculated calculated
Houston-Pasadena-The Woodlands, TX27$5,192,8133,01859
Mobile, AL13$1,888,75294665
Birmingham, AL20$1,817,33591735
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD17$1,353,79198253
New York-Newark-Jersey City, NY-NJ16$763,1972,58853
Albany-Schenectady-Troy, NY14$640,04971138
Kansas City, MO-KS19$231,8553,304106
Salt Lake City-Murray, UT11$82,4501,167100
Atlanta-Sandy Springs-Roswell, GA17$72,34135719
Tulsa, OK13$43,81148134
Boston-Cambridge-Newton, MA-NH11$39,41350840
Jackson, MS12$19,57328620

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 12 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing 78431 nationally

Cardiology accounts for 63% of payment for 78431 nationally in 2020, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Cardiology29865%$14,548,82263%21,56372
Interventional Cardiology5712%$6,159,34527%4,87886
Diagnostic Radiology4610%$574,2782.5%1,77038
Nuclear Medicine337.2%$337,2241.5%2,58078
Internal Medicine112.4%$23,5070.10%32730

Not listed: 5 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2020.

Top billers of 78431 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations