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 | $1639.00 | 1023074028 - GEORGE COUNTY HOSPITAL | 646001398 | MS | Rural Acute Care Hospital (282NR1301X) |
United | 0404 | $3186.00 | 1518957950 - BOLIVAR GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE BOLIVAR HOSPITAL | 621624171 - (TN) BOLIVAR GENERAL HOSPITAL INC | TN | Critical Access Hospital (282NC0060X) |
United | 0404 | $3360.00 | 1114931342 - INTEGRIS MIAMI HOSPITAL, INTEGRIS MIAMI HOSPITAL | 730584411 | OK | General Acute Care Hospital (282N00000X) |
United | 0404 | $5118.00 | 1629057229 - AHS HILLCREST MEDICAL CENTER, LLC, HILLCREST MEDICAL CENTER | 770633896 - (OK) AHS HILLCREST MEDICAL CENTER LLC | OK | General Acute Care Hospital (282N00000X) |
United | 0404 | $5017.00 | 1801320718 - STEWARD MELBOURNE HOSPITAL, INC. | 815354550 | FL | General Acute Care Hospital (282N00000X) |
United | 0404 | $5549.00 | 1801826912 - WELLMONT HEALTH SYSTEM, LONESOME PINE HOSPITAL | 621636465 - WELLMONT HEALTH SYSTEM | VA | General Acute Care Hospital (282N00000X) |
United | 0404 | $2839.00 | 1649226952 - ANDERSON REGIONAL MEDICAL CENTER, ANDERSON REGIONAL MEDICAL CENTER | 640362400 - (MS) ANDERSON REGIONAL MEDICAL CENTER | MS | General Acute Care Hospital (282N00000X) |
United | 0404 | $5494.00 | 1467595793 - TRUMAN MEDICAL CENTER, INCORPORATED, UNIVERSITY HEALTH TRUMAN MEDICAL CENTER | 440661018 - (MO) TRUMAN MEDICAL CENTER INCORPORATED | MO | 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 | $2235.00 | 1124073879 - ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC, ATMORE COMMUNITY HOSPITAL | 631143638 - ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC | AL | Rural Acute Care Hospital (282NR1301X) |
United | 0404 | $4323.00 | 1225195340 - INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL, INC. | 350867958 - (IN) INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 0404 | $1902.00 | 1417944224 - IREDELL MEMORIAL HOSPITAL, INCORPORATED | 560591303 - (NC) IREDELL MEMORIAL HOSPITAL INCORPORATED | NC | General Acute Care Hospital (282N00000X) |
United | 0404 | $3121.00 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | General Acute Care Hospital (282N00000X) |
United | 0404 | $2122.00 | 1083659734 - NESHOBA COUNTY GENERAL HOSPITAL | 646000892 | MS | General Acute Care Hospital (282N00000X) |
United | 0404 | $5793.00 | 1124058615 - WELLMONT HEALTH SYSTEM, BRISTOL REGIONAL MEDICAL CENTER | 621636465 - WELLMONT HEALTH SYSTEM | 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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