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Revenue Code (RC) 0404 Fee Schedule

Last Verified: September 2026

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 FactDetail
Service Type

Other Imaging Services

Complexity LevelModerate

National average reimbursement for Revenue Code 0404 by major payers:

bcbs

$721.06

uhc

$3,344.43

aetna

$4,552.40

cigna

$3,638.52

Compare published rates across providers.

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RC 0404
5 of 25 sample ratesHigher to lower in this preview
  1. Mountain States Health Alliance, Russell County Hospital

    VAGeneral Acute Care HospitalNPI 1891973939Tax ID 54-1594711

    $7,811.00Published rate
  2. Truman Medical Center, Incorporated, University Health Truman Medical Center

    Truman Medical Center Incorporated

    MOGeneral Acute Care HospitalNPI 1467595793Tax ID 44-0661018

    $5,494.00Published rate
  3. Providence Hospital

    Usa Health Hca Providence Hospital LLC

    ALGeneral Acute Care HospitalNPI 1952390643Tax ID 93-1394239

    $3,485.00Published rate
  4. Anderson Regional Medical Center, Anderson Regional Medical Center South Campus

    Anderson Regional Medical Center

    MSGeneral Acute Care HospitalNPI 1215233986Tax ID 64-0362400

    $2,839.00Published rate
  5. Maury Regional Hospital, Wayne Medical Center

    Maury Regional Hospital

    TNGeneral Acute Care HospitalNPI 1811927544Tax ID 62-1605071

    $1,272.00Published rate

National sample. Rates vary by location, specialty, and contract.

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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.

CodeComplexityDescription
0403-RCModerateScreening mammography
0404-RCModeratePositron Emission Tomography
0405-RCLowOther Imaging Services

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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