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CPT 78099 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Unlisted Endocrine Procedure, Diagnostic Nucl.Ear Medicine
Key FactDetail
Service Type

Radiology Procedures

Nuclear Medicine Procedures

Common Place of Service

22 - On Campus Outpatient Hospital

Common Modifiers

None

26 - Professional component

TC - Technical component

Complexity LevelHigh

National average reimbursement for CPT 78099 by major payers:

bcbs

$1,381.24

uhc

$110.54

aetna

$203.83

cigna

$758.27

Preview provider-level rates for...
For billing codeCPT 78099
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 78099

United
78099$467.251366097032 - INSPIRA MEDICAL CENTERS, INC.210634484 - (NJ) INSPIRA MEDICAL CENTERS INCNJGeneral Acute Care Hospital (282N00000X)
United
78099$165.861235685892 - FAIRFIELD HOSPITAL DISTRICT, FREESTONE MEDICAL CENTER741774669TXGeneral Acute Care Hospital (282N00000X)
United
78099$736.261225081516 - GADSDEN REGIONAL MEDICAL CENTER LLC, GADSDEN REGIONAL MEDICAL CENTER631102774ALGeneral Acute Care Hospital (282N00000X)
United
78099$377.111265818488 - SMSJ TUCSON HOLDINGS LLC, ST. MARYS HOSPITAL474131755AZGeneral Acute Care Hospital (282N00000X)
United
78099$594.041053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INCFLGeneral Acute Care Hospital (282N00000X)
United
78099$377.111215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
78099$736.261215981303 - VICKSBURG HEALTHCARE LLC, MERIT HEALTH RIVER REGION621752111 - (MS) VICKSBURG HEALTHCARE LLCMSGeneral Acute Care Hospital (282N00000X)
United
78099$377.111013386143 - EOH ACQUISITION GROUP, LLC, CAREWELL HEALTH MEDICAL CENTER854153331 - (NJ) EOH ACQUISITIONS GROUP, LLC DBA CAREWELL HEALTHNJGeneral Acute Care Hospital (282N00000X)
United
78099$395.981063494177 - ST LUKES HOSPITAL OF KANSAS CITY, SAINT LUKE'S HOSPITAL OF KANSAS CITY440545297 - ST LUKES HOSPITAL OF KANSAS CITYMOGeneral Acute Care Hospital (282N00000X)
United
78099$265.921295772259 - LAKEVIEW MEDICAL CENTER, LLC, LAKEVIEW REGIONAL MEDICAL CENTER621596506LAGeneral Acute Care Hospital (282N00000X)
United
78099$866.221609971019 - SCURRY COUNTY HOSPITAL DISTRICT, COGDELL MEMORIAL HOSPITAL752403687 - (TX) SCURRY COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
78099$848.521295723229 - ST FRANCIS MEDICAL CENTER, INC720408970 - (LA) ST FRANCIS MEDICAL CENTER INCLAGeneral Acute Care Hospital (282N00000X)
United
78099$866.221356307581 - NEBRASKA MEDICAL CENTER, THE NEBRASKA MEDICAL CENTER - NEBRASKA MEDICINE911858433 - (NE) THE NEBRASKA MEDICAL CENTERNEGeneral Acute Care Hospital (282N00000X)
United
78099$377.111538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
78099$848.521720038946 - HCA HEALTHONE LLC, PRESBYTERIAN/ST. LUKE'S MEDICAL CENTER841321373COGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 78099 vs. Other Nuclear Medicine Procedures Codes

The CPT 78099 code is part of the Radiology Procedures services used for Nuclear Medicine Procedures. 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 CPT 78099 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
78099-CPTHighUnlisted Endocrine Procedure, Diagnostic Nucl.Ear Medicine
78104-CPTModerateBone Marrow Imaging; Whole Body
78110-CPTLowPlasma Vol,Radionucl.Vol-Dil;1 Samp
78120-CPTLowRed Cell Mass (Volume) Determination

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78099. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 78099 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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