Cost analysis for CPT 78816 — Nuclear medicine study whole body with ct scan
Average Medicare Payment
$467.79
2023 data
Total Payments (2023)
$37.7M
Services (2023)
84.4K
Price Change (2014–2023)
-16.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $557.96 | $25.4M | 43.7K | — |
| 2015 | $522.27 | $25.2M | 46.3K | -6.4% |
| 2016 | $487.08 | $25.9M | 50.8K | -6.7% |
| 2017 | $498.55 | $28.0M | 54.7K | +2.4% |
| 2018 | $476.28 | $23.9M | 51.8K | -4.5% |
| 2019 | $484.08 | $24.4M | 56.2K | +1.6% |
| 2020 | $488.57 | $24.3M | 54.7K | +0.9% |
| 2021 | $496.20 | $28.6M | 64.2K | +1.6% |
| 2022 | $496.35 | $32.8M | 71.4K | +0.0% |
| 2023 | $467.79 | $37.7M | 84.4K | -5.8% |
The most expensive state pays 12.8x more than the cheapest for this procedure. AK averages $1052.72 vs VT at $82.00.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $1052.72 | $223.2K | 212 | 4 |
| PR | $978.32 | $164.4K | 168 | 7 |
| NV | $918.88 | $409.8K | 446 | 22 |
| AL | $795.24 | $504.2K | 634 | 22 |
| MD | $771.95 | $2.1M | 2.7K | 58 |
| NJ | $718.09 | $1.2M | 1.7K | 50 |
| HI | $669.08 | $127.1K | 190 | 5 |
| FL | $658.76 | $5.1M | 7.8K | 121 |
| CA | $653.06 | $6.5M | 9.9K | 207 |
| NM | $626.92 | $168.6K | 269 | 15 |
| NY | $590.71 | $4.5M | 7.7K | 142 |
| AZ | $551.21 | $1.1M | 2.0K | 56 |
| MA | $515.31 | $1.7M | 3.4K | 60 |
| CO | $483.77 | $772.6K | 1.6K | 42 |
| VA | $469.81 | $1.2M | 2.6K | 63 |
| ID | $459.02 | $145.1K | 316 | 13 |
| AR | $435.05 | $981.0K | 2.3K | 38 |
| NE | $405.90 | $304.8K | 751 | 24 |
| KS | $391.93 | $363.3K | 927 | 22 |
| ME | $384.33 | $116.8K | 304 | 13 |
| LA | $366.73 | $137.2K | 374 | 15 |
| PA | $358.33 | $1.1M | 3.0K | 81 |
| TX | $351.72 | $2.8M | 8.0K | 153 |
| WA | $350.08 | $627.4K | 1.8K | 34 |
| OR | $326.79 | $266.0K | 814 | 26 |
| TN | $319.01 | $430.3K | 1.3K | 39 |
| IN | $292.44 | $304.4K | 1.0K | 35 |
| WI | $280.92 | $306.8K | 1.1K | 30 |
| IL | $266.15 | $699.7K | 2.6K | 75 |
| OK | $264.75 | $255.2K | 964 | 33 |
| RI | $259.33 | $69.0K | 266 | 8 |
| CT | $244.90 | $118.3K | 483 | 17 |
| OH | $237.33 | $466.6K | 2.0K | 38 |
| KY | $225.71 | $102.5K | 454 | 17 |
| MN | $218.77 | $461.4K | 2.1K | 61 |
| MS | $215.30 | $136.3K | 633 | 23 |
| DC | $211.77 | $39.0K | 184 | 5 |
| SC | $209.33 | $300.8K | 1.4K | 44 |
| NH | $192.99 | $85.7K | 444 | 8 |
| SD | $177.67 | $48.5K | 273 | 8 |
| GA | $177.17 | $284.4K | 1.6K | 49 |
| DE | $174.86 | $49.7K | 284 | 9 |
| IA | $149.94 | $125.8K | 839 | 16 |
| MI | $141.57 | $199.5K | 1.4K | 47 |
| NC | $113.33 | $344.1K | 3.0K | 60 |
| MO | $94.83 | $128.6K | 1.4K | 39 |
| MT | $89.50 | $11.3K | 126 | 6 |
| ND | $86.29 | $8.9K | 103 | 3 |
| UT | $86.24 | $15.4K | 178 | 7 |
| WV | $84.60 | $16.7K | 197 | 4 |
| VT | $82.00 | $16.9K | 206 | 5 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Paul Makhlouf | Nuclear Medicine | FL | $435.9K | 351 | $1241.91 |
| Ronald Goodwich | Diagnostic Radiology | FL | $425.7K | 353 | $1205.85 |
| Lisa Kalimi | Nuclear Medicine | NY | $288.9K | 187 | $1544.86 |
| Patrick Gonzales | Diagnostic Radiology | CA | $279.8K | 171 | $1636.31 |
| Ron Rosen | Nuclear Medicine | NY | $277.2K | 191 | $1451.23 |
| Sherif Heiba | Nuclear Medicine | NY | $253.7K | 167 | $1519.00 |
| Asad Nasir | Nuclear Medicine | OH | $223.1K | 186 | $1199.62 |
| Abbas Tuli | Diagnostic Radiology | NY | $215.1K | 142 | $1514.70 |
| Edward Mcclay | Internal Medicine | CA | $209.5K | 142 | $1475.38 |
| Marc Prager | Nuclear Medicine | NY | $205.1K | 133 | $1541.89 |
| Simon Gabriel | Diagnostic Radiology | CA | $189.4K | 128 | $1479.93 |
| Thomas Lank | Diagnostic Radiology | MD | $187.9K | 255 | $736.82 |
| Umass Memorial Mri & Imaging Center, Llc | Independent Diagnostic Testing Facility (IDTF) | MA | $184.5K | 149 | $1238.31 |
| Wei Shen Griggs | Diagnostic Radiology | VA | $182.8K | 122 | $1498.07 |
| Shawn Carter | Nuclear Medicine | FL | $182.1K | 154 | $1182.35 |
| Navid Moradshahi | Interventional Radiology | CA | $178.6K | 118 | $1513.60 |
| Robert Mcdonald | Nuclear Medicine | FL | $174.0K | 139 | $1251.89 |
| Abida Taher | Nuclear Medicine | FL | $168.6K | 138 | $1221.49 |
| Shields Imaging Of Eastern Massachusetts Llc | Independent Diagnostic Testing Facility (IDTF) | MA | $168.0K | 120 | $1399.62 |
| Medina Kushen | Nuclear Medicine | FL | $167.9K | 142 | $1182.09 |
The data suggests significant pricing inconsistencies for CPT 78816. With a 12.8x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 16.2% since 2014, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.