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See a sample rate comparisonCPT 78104 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.
Scan Of Bone Marrow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Bone Marrow On A Scan So That It May Be Viewed More Easily. The Entire Body May Be Scanned. Multiple Images May Be Taken.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component MG - The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78104 |
| Medicaid Fee Schedule | View Medicaid rates for 78104 |
National average reimbursement for CPT 78104 by major payers:
$284.34
$283.22
$272.96
$342.06
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CPT 78104
5 of 25 sample ratesHigher to lower in this preview
Parag Shah
Radiology Associates Of North Texas, PA
$644.21Published rateMuhammad Shahid
Northern Arizona Healthcare Corporation
$406.20Published rateSally Mcfarlane-Parrott
Northern Arizona Healthcare Corporation
$337.79Published rateMichael Gouvion
Radiology Associates Of North Texas, PA
$98.36Published rateSamuel Weimer
Northern Arizona Healthcare Corporation
$33.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78104 vs. Other Nuclear Medicine Procedures Codes
The CPT 78104 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 78104 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.
| Code | Complexity | Description |
|---|---|---|
| 78099-CPT | High | Scan Of Hormone System, After Giving A Radioactive Substance By Mouth Or Iv The Glands That Make Up The Hormone (Endocrine) System Can Be Viewed. |
| 78102-CPT | Moderate | Scan Of Bone Marrow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Bone Marrow On A Scan So That It May Be Viewed More Easily. The Entire Body May Be Scanned. Multiple Images May Be Taken. |
| 78103-CPT | Moderate | Scan Of Bone Marrow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Bone Marrow On A Scan So That It May Be Viewed More Easily. The Entire Body May Be Scanned. Multiple Images May Be Taken. |
| 78104-CPT | Moderate | Scan Of Bone Marrow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Bone Marrow On A Scan So That It May Be Viewed More Easily. The Entire Body May Be Scanned. Multiple Images May Be Taken. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78104. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78104 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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