CPT 78191 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Nuclear Medicine Procedures |
| Common Place of Service | • 11 - Office |
| Common Modifiers | • None |
| Complexity Level | Low |
National average reimbursement for CPT 78191 by major payers:

$171.83

$192.53

$163.09

$226.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 78191 | ||||||
United | 78191 | $363.60 | 1497118665 - CLETUS FUHRMANN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | OK | Diagnostic Radiology Physician (2085R0202X) |
United | 78191 | $77.58 | 1194169847 - JUSTIN RAMIREZ | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78191 | $110.12 | 1053304766 - TIMOTHY KAVANAUGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Orthopaedic Surgery Physician (207X00000X) |
United | 78191 | $279.00 | 1548647472 - SEAN LARSEN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 78191 | $330.60 | 1780998237 - NEEJA DAVE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78191 | $77.58 | 1497747653 - LUCIANA ROCHETTI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 78191 | $77.58 | 1487637914 - MATTHEW GLASER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78191 | $363.60 | 1487828596 - CHARLES CRUM | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78191 | $75.50 | 1942081153 - HEALTH IMAGING PARTNERS LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 78191 | $441.20 | 1124664982 - BRILYN AKERLEY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 78191 | $77.58 | 1841863529 - SYDNEY ROSE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Nurse Practitioner (363L00000X) |
United | 78191 | $330.60 | 1396127775 - CARLOS MARTINEZ PARRA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IL | Anesthesiology Physician (207L00000X) |
United | 78191 | $208.50 | 1821382409 - BENJAMIN WILSON | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | PA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78191 | $441.20 | 1700318102 - STEVEN LEE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78191 | $441.20 | 1699201509 - SERENA JEN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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.
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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