HCPCS 78431

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

Imaging Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

1,016
86th percentile among 6,326 codes billed · 2022
$100M
98th percentile among 6,326 codes billed · 2022
97K
85th percentile among 6,326 codes billed · 2022
43
71st percentile among 6,326 codes billed · 2022
295
74th percentile among 6,326 codes billed · 2022
+83.1%
Medicare payment on the code vs 2021; billers +47.0% · 2022

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
Texas112$18,581,44812,34658350
Illinois45$18,501,01513,76653419
California51$13,168,2859,08546357
Florida88$12,209,7117,63872278
Pennsylvania76$7,408,1845,62464171
New York56$6,376,2686,76062473
Alabama41$6,055,5743,72257227
New Jersey21$5,241,4582,74468469
Louisiana13$2,416,6682,145114479
Mississippi22$2,171,1792,16455311
Nevada39$1,328,6051,54927102
Arkansas17$1,172,5923,472161503
Utah30$815,8513,317111202
Arizona17$765,4711,63754279
Kentucky24$401,2729721966

Not listed: 11 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 2022.

Top metro areas

observed calculated calculated calculated calculated
Chicago-Naperville-Elgin, IL-IN43$18,488,98513,59449
Houston-Pasadena-The Woodlands, TX71$15,498,6998,93668
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD74$11,833,1906,61376
Los Angeles-Long Beach-Anaheim, CA23$11,039,9546,89898
New York-Newark-Jersey City, NY-NJ32$4,945,9645,21566
Mobile, AL18$3,118,8441,926102
Miami-Fort Lauderdale-West Palm Beach, FL14$2,203,6391,19770
Birmingham, AL20$2,073,3461,27840
Cape Coral-Fort Myers, FL12$1,776,85794286
Las Vegas-Henderson-North Las Vegas, NV36$1,325,8931,51030
Little Rock-North Little Rock-Conway, AR16$1,170,5423,442167
Albany-Schenectady-Troy, NY13$1,141,73591767
North Port-Bradenton-Sarasota, FL15$722,10873240
Kansas City, MO-KS33$294,3434,49278
Boston-Cambridge-Newton, MA-NH17$161,90694330

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 26 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 78431 nationally

Cardiology accounts for 60% of payment for 78431 nationally in 2022, across 5 specialties on claims.

observed calculated calculated calculated calculated calculated
Cardiology70669%$59,655,41560%60,50886
Interventional Cardiology12713%$13,906,29614%12,14196
Nuclear Medicine515.0%$1,557,0401.6%3,52069
Diagnostic Radiology686.7%$994,0160.99%3,09846
Internal Medicine333.2%$864,2030.86%1,57448

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 2022.

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