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See a sample rate comparisonCPT 78191 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.
Study Of Blood Cell Life Cycle, This Study Assesses The Health Of Platelets A Blood Component By Evaluating The Cells Life Cycle After Introducing A Radioactive Substance To A Blood Sample.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 11 - Office |
| Common Modifiers | None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78191 |
| Medicaid Fee Schedule | View Medicaid rates for 78191 |
National average reimbursement for CPT 78191 by major payers:
$171.83
$192.53
$163.09
$224.30
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CPT 78191
5 of 25 sample ratesHigher to lower in this preview
Steven Lee
Radiology Associates Of North Texas, PA
$441.20Published rateMazi Condelee
Northern Arizona Healthcare Corporation
$330.60Published rateChristopher Raio
St Francis Hospital
$171.47Published rateMark Gordon
Northern Arizona Healthcare Corporation
$87.73Published rateAlexander Igoe
Northern Arizona Healthcare Corporation
$51.61Published rate
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See a sample payer proposalCPT 78191 vs. Other Nuclear Medicine Procedures Codes
The CPT 78191 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 78191 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 |
|---|---|---|
| 78185-CPT | Low | Scan Of The Spleen, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Spleen Tissue On A Scan. Blood Flow To From And Within The Organ May Also Be Viewed. |
| 78191-CPT | Low | Study Of Blood Cell Life Cycle, This Study Assesses The Health Of Platelets A Blood Component By Evaluating The Cells Life Cycle After Introducing A Radioactive Substance To A Blood Sample. |
| 78199-CPT | High | Scan Of Blood Or Lymph Flow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Blood Or Lymph Fluid Cells On A Scan So That They May Be Viewed More Easily. |
| 78215-CPT | Moderate | Scan Of Liver And Spleen, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Liver And Spleen On A Scan So That Their Function Is Viewed More Easily. Blood Flow Through The Organs May Be Viewed. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78191. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78191 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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