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See a sample rate comparisonHealthcare 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.
| 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 MG - The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78122 |
| Medicaid Fee Schedule | View Medicaid rates for 78122 |
National average reimbursement for CPT 78122 by major payers:

$123.45

$132.49

$119.19

$157.20
Choose a payer to see a sample of rates for CPT 78122.
Radiology Associates Of North Texas, PA
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
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Rate Benchmarking
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See a sample payer proposalCPT 78122 vs. Other Nuclear Medicine Procedures Codes
The CPT 78122 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 78122 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 78122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78122 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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