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See a sample rate comparisonCPT 78130 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 Survival Study, The Study Involves The Injection Of A Radioactive Material To Assess How Long Red Blood Cells Survive After The Injection. The Test May Be Used To Diagnose And Manage A Blood Condition.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 20 - Urgent Care Facility 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78130 |
| Medicaid Fee Schedule | View Medicaid rates for 78130 |
National average reimbursement for CPT 78130 by major payers:
$158.29
$161.75
$151.33
$195.95
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CPT 78130
5 of 25 sample ratesHigher to lower in this preview
James Montgomery
Radiology Associates Of North Texas, PA
$441.20Published rateEdward Jackman
Northern Arizona Healthcare Corporation
$252.00Published rateChristopher Raio
St Joseph Hospital
$171.79Published rateJessica Kerr
Northern Arizona Healthcare Corporation
$87.73Published rateSami Nasrallah
Northern Arizona Healthcare Corporation
$52.20Published rate
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See a sample payer proposalCPT 78130 vs. Other Nuclear Medicine Procedures Codes
The CPT 78130 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 78130 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 |
|---|---|---|
| 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. |
| 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. |
| 78130-CPT | Low | Blood Cell Survival Study, The Study Involves The Injection Of A Radioactive Material To Assess How Long Red Blood Cells Survive After The Injection. The Test May Be Used To Diagnose And Manage 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 78130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78130 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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