HCPCS 78431

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

Imaging Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

691
83rd percentile among 6,253 codes billed · 2021
$55M
96th percentile among 6,253 codes billed · 2021
60K
81st percentile among 6,253 codes billed · 2021
44
71st percentile among 6,253 codes billed · 2021
266
73rd percentile among 6,253 codes billed · 2021
+138.4%
Medicare payment on the code vs 2020; billers +50.5% · 2021

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
Texas66$15,537,90110,083111466
Florida71$10,711,0676,13561245
Alabama38$5,879,5683,50761207
Illinois21$4,449,9583,55947260
New York37$3,473,7964,92065499
California28$3,334,7012,56551269
Pennsylvania40$2,759,8103,12347246
New Jersey13$2,060,92295218284
Mississippi21$1,824,3211,83347263
Arkansas11$1,127,9612,32393800
Utah28$868,2253,240104223
Kentucky14$368,75975321193
Ohio26$269,7541,60361116
Missouri21$249,1903,72893486
Georgia22$98,9065362238

Not listed: 16 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 2021.

Top metro areas

observed calculated calculated calculated calculated
Houston-Pasadena-The Woodlands, TX46$13,078,9217,48199
Chicago-Naperville-Elgin, IL-IN20$4,443,3293,46143
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD32$3,221,1392,14149
Mobile, AL15$2,761,2081,659115
New York-Newark-Jersey City, NY-NJ24$2,618,9773,89669
Miami-Fort Lauderdale-West Palm Beach, FL13$2,617,0161,38580
Birmingham, AL19$2,121,3351,25839
Cape Coral-Fort Myers, FL12$1,544,10681667
Albany-Schenectady-Troy, NY13$981,29482454
Kansas City, MO-KS22$261,7383,932101
Atlanta-Sandy Springs-Roswell, GA15$88,38538222
Boston-Cambridge-Newton, MA-NH14$87,56074840
Lincoln, NE11$50,57476871
Jackson, MS16$48,32973145
Louisville/Jefferson County, KY-IN12$45,94431919

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 18 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing 78431 nationally

Cardiology accounts for 64% of payment for 78431 nationally in 2021, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Cardiology45265%$34,971,30164%39,25687
Interventional Cardiology8112%$9,632,80918%7,63494
Nuclear Medicine517.4%$1,503,9422.8%3,56170
Diagnostic Radiology639.1%$1,065,8671.9%2,45639
Internal Medicine223.2%$339,5890.62%95744

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 2021.

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