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CPT 78111 Fee Schedule

Last Verified: December 2025

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.

Plasma Vol,Radionuclide Vol-Dilut.Tech;M
Key FactDetail
Service Type

Radiology Procedures

Nuclear Medicine Procedures

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

26 - Professional component

52 - Reduced Services

Complexity LevelLow

National average reimbursement for CPT 78111 by major payers:

bcbs

$97.13

uhc

$98.85

aetna

$91.18

cigna

$121.08

Preview provider-level rates for...
For billing codeCPT 78111
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 78111

United
78111$8.271669457206 - ANANYA DAS742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZGastroenterology Physician (207RG0100X)
United
78111$162.001033494901 - JULIE POLZIN742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZFamily Nurse Practitioner (363LF0000X)
United
78111$142.801255458469 - JEANNINE PAQUETTE742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZSurgical Physician Assistant (363AS0400X)
United
78111$19.201649237678 - ANITA EISENHART742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONNYEmergency Medicine Physician (207P00000X)
United
78111$8.271689023228 - HAMISH PATEL742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONFLInternal Medicine Physician (207R00000X)
United
78111$27.961912394495 - ENIOLA FAGBONGBE751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PACADiagnostic Radiology Physician (2085R0202X)
United
78111$224.661740506583 - JOSEPH SCHULTZ751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PAILDiagnostic Radiology Physician (2085R0202X)
United
78111$252.631043297260 - JOE NIEHUS751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXDiagnostic Radiology Physician (2085R0202X)
United
78111$162.001659670115 - JESSICA REED742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZAcute Care Nurse Practitioner (363LA2100X)
United
78111$64.731548645021 - JELISA VICK742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONNMAcute Care Nurse Practitioner (363LA2100X)
United
78111$162.001255458469 - JEANNINE PAQUETTE742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZSurgical Physician Assistant (363AS0400X)
United
78111$19.201073554226 - MICHAEL SULEIMAN742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZAnesthesiology Physician (207L00000X)
United
78111$142.801659508570 - RAJEEV FERNANDO742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONNYInfectious Disease Physician (207RI0200X)
United
78111$224.661093716631 - DOUGLAS TRIPPE751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXDiagnostic Radiology Physician (2085R0202X)
United
78111$13.261235122029 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
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 78111 vs. Other Nuclear Medicine Procedures Codes

The CPT 78111 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 78111 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
78110-CPTLowPlasma Vol,Radionucl.Vol-Dil;1 Samp
78111-CPTLowPlasma Vol,Radionuclide Vol-Dilut.Tech;M
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 78111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 78111 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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