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See a sample rate comparisonCPT 78111 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.
Blood Cell Study, This Study Evaluates One Or More Blood Components Such As Plasma And Blood Cells After Injection Of A Radioactive Material. The Test May Help To Detect A Blood Condition.
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78111 |
| Medicaid Fee Schedule | View Medicaid rates for 78111 |
National average reimbursement for CPT 78111 by major payers:
$97.13
$98.85
$91.18
$119.49
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CPT 78111
5 of 25 sample ratesHigher to lower in this preview
Gregory Schaiberger
Radiology Associates Of North Texas, PA
$252.63Published rateMichael Mirzoyan
Northern Arizona Healthcare Corporation
$162.00Published rateAlyssa Norman
Northern Arizona Healthcare Corporation
$106.54Published rateWilliam Zimmer
Radiology Associates Of North Texas, PA
$56.45Published rateAnanya Das
Northern Arizona Healthcare Corporation
$8.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 78110-CPT | Low | Blood Cell Study, This Study Evaluates One Or More Blood Components Such As Plasma And Blood Cells After Injection Of A Radioactive Material. The Test May Help To Detect A Blood Condition. |
| 78111-CPT | Low | Blood Cell Study, This Study Evaluates One Or More Blood Components Such As Plasma And Blood Cells After Injection Of A Radioactive Material. The Test May Help To Detect A Blood Condition. |
| 78120-CPT | Low | Blood Cell Study, This Study Evaluates One Or More Blood Components Such As Plasma And Blood Cells After Injection Of A Radioactive Material. The Test May Help To Detect A Blood Condition. |
| 78122-CPT | Low | Blood Cell Study, This Study Evaluates One Or More Blood Components Such As Plasma And Blood Cells After Injection Of A Radioactive Material. The Test May Help To Detect A Blood Condition. |
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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