HCPCS 78431

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

Imaging Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

1,377
88th percentile among 6,405 codes billed · 2023
$163M
99th percentile among 6,405 codes billed · 2023
135K
87th percentile among 6,405 codes billed · 2023
51
74th percentile among 6,405 codes billed · 2023
309
74th percentile among 6,405 codes billed · 2023
+63.3%
Medicare payment on the code vs 2022; billers +35.5% · 2023

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
Texas159$31,015,80819,17968375
Florida138$24,192,35612,27462322
Illinois56$22,775,36717,43577449
California100$22,327,58415,39056338
Pennsylvania98$12,112,1837,97273191
Alabama47$7,826,5254,20862233
New York70$7,220,7587,43262373
New Jersey31$6,906,2253,78170392
Virginia54$5,292,9362,99934182
Louisiana25$3,971,6612,89852330
Mississippi44$3,778,4783,09741277
Nevada42$3,704,4893,54533348
Arizona33$2,696,0723,20443326
Kansas26$1,176,5691,73049170
Arkansas16$1,092,8393,121148458

Not listed: 12 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 2023.

Top metro areas

observed calculated calculated calculated calculated
Houston-Pasadena-The Woodlands, TX96$25,409,87313,95993
Chicago-Naperville-Elgin, IL-IN45$21,966,52416,60677
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD92$19,692,90810,35784
Los Angeles-Long Beach-Anaheim, CA51$18,251,61111,42657
New York-Newark-Jersey City, NY-NJ55$5,847,4526,16760
Ocala, FL11$4,709,3832,277192
Miami-Fort Lauderdale-West Palm Beach, FL21$4,337,4881,94561
Washington-Arlington-Alexandria, DC-VA-MD-WV19$3,850,9791,86380
Las Vegas-Henderson-North Las Vegas, NV34$3,647,0643,35938
Mobile, AL17$3,589,0721,938101
North Port-Bradenton-Sarasota, FL21$3,023,0951,65051
Amarillo, TX13$2,991,5362,312139
Orlando-Kissimmee-Sanford, FL16$2,448,5621,18461
Cape Coral-Fort Myers, FL11$2,435,7811,09071
Birmingham, AL18$2,359,2901,27440

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 36 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing 78431 nationally

Cardiology accounts for 62% of payment for 78431 nationally in 2023, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Cardiology93468%$101,071,09762%85,37891
Interventional Cardiology21315%$24,829,06915%18,33386
Clinical Cardiac Electrophysiology292.1%$2,873,7691.8%1,69558
Nuclear Medicine574.1%$1,865,0041.1%3,78866
Internal Medicine423.1%$1,542,5050.94%2,41758
Diagnostic Radiology715.2%$1,418,0030.87%4,08958
Advanced Heart Failure and Transplant Cardiology130.94%$288,1190.18%86767

Not listed: 9 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 2023.

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