Revenue Code (RC) 0404 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Positron Emission Tomography
| Key Fact | Detail |
|---|---|
| Service Type | • Other Imaging Services |
| Complexity Level | Moderate |
National average reimbursement for Revenue Code 0404 by major payers:

$721.06

$3,344.43

$4,552.40

$3,638.52
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for RC 0404 | ||||||
United | 0404 | $2869.00 | 1699754812 - HARDIN COUNTY GENERAL HOSPITAL, HARDIN MEDICAL CENTER | 626002428 - (TN) HARDIN COUNTY GENERAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0404 | $1800.00 | 1144236571 - INTEGRIS BASS BAPTIST HEALTH CENTER, INTEGRIS BASS BAPTIST HEALTH CENTER | 730612674 | OK | General Acute Care Hospital (282N00000X) |
United | 0404 | $2903.00 | 1699765453 - MILAN GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE MILAN HOSPITAL | 621753289 - (TN) MILAN GENERAL HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 0404 | $3838.00 | 1225289499 - LUBBOCK HERITAGE HOSPITAL, LLC., GRACE SURGICAL HOSPITAL | 264021016 - (TX) LUBBOCK HERITAGE HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0404 | $1272.00 | 1811927544 - MAURY REGIONAL HOSPITAL, WAYNE MEDICAL CENTER | 621605071 - (TN) MAURY REGIONAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0404 | $5767.00 | 1104859131 - HOLY NAME MEDICAL CENTER INC., HOLY NAME HOSPITAL | 221487322 - (NJ) HOLY NAME MEDICAL CENTER INC | NJ | General Acute Care Hospital (282N00000X) |
United | 0404 | $2500.00 | 1558349399 - HEART OF TEXAS HEALTHCARE SYSTEM, HEART OF TEXAS MEMORIAL HOSPITAL | 320326595 - (TX) HEART OF TEXAS MEMORIAL HOSPITAL | TX | Critical Access Hospital (282NC0060X) |
United | 0404 | $2133.00 | 1629025648 - SAINT THOMAS WEST HOSPITAL, ASCENSION SAINT THOMAS HOSPITAL | 620347580 - (TN) SAINT THOMAS WEST HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 0404 | $4323.00 | 1548260284 - INDIANA UNIVERSITY HEALTH BEDFORD, INC, IU HEALTH BEDFORD HOSPITAL | 237042323 - (IN) INDIANA UNIVERSITY HEALTH BEDFORD INC | IN | Critical Access Hospital (282NC0060X) |
United | 0404 | $5017.00 | 1801320718 - STEWARD MELBOURNE HOSPITAL, INC. | 815354550 | FL | General Acute Care Hospital (282N00000X) |
United | 0404 | $2903.00 | 1518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL | 621624171 - (TN) BOLIVAR GENERAL HOSPITAL INC | TN | Critical Access Hospital (282NC0060X) |
United | 0404 | $2839.00 | 1215233986 - ANDERSON REGIONAL MEDICAL CENTER, ANDERSON REGIONAL MEDICAL CENTER SOUTH CAMPUS | 640362400 - (MS) ANDERSON REGIONAL MEDICAL CENTER | MS | General Acute Care Hospital (282N00000X) |
United | 0404 | $5793.00 | 1801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL | 621636465 - WELLMONT HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 0404 | $3485.00 | 1952390643 - PROVIDENCE HOSPITAL | 931394239 - (AL) USA HEALTH HCA PROVIDENCE HOSPITAL LLC | AL | General Acute Care Hospital (282N00000X) |
United | 0404 | $2903.00 | 1699765453 - MILAN GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE MILAN HOSPITAL | 621753289 - (TN) MILAN GENERAL HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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Revenue Code 0404 vs. Other Other Imaging Services Codes
The Revenue Code 0404 code is part of the Other Imaging Services services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The Revenue Code 0404 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including Revenue Code 0404. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0404 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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