CPT 78215 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78215 |
National average reimbursement for CPT 78215 by major payers:

$215.13

$218.62

$216.22

$273.00
| 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 78215 | ||||||
United | 78215 | $20.86 | 1508829912 - ALGIMANTAS JECIUS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgery Physician (208600000X) |
United | 78215 | $150.61 | 1700390861 - DYMAN KWARCIAK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IL | Hospice and Palliative Medicine (Family Medicine) Physician (207QH0002X) |
United | 78215 | $132.72 | 1891276630 - BRIAN ANDREW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 78215 | $301.19 | 1972913770 - JEREMY ALVORD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 78215 | $301.19 | 1952332470 - MARGARET KOBE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Infectious Disease Physician (207RI0200X) |
United | 78215 | $35.61 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 78215 | $41.40 | 1043718950 - DANIEL HAINLEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Certified Registered Nurse Anesthetist (367500000X) |
United | 78215 | $171.47 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | LA | Internal Medicine Physician (207R00000X) |
United | 78215 | $150.61 | 1487161733 - MELISSA YOUNKINS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 78215 | $259.77 | 1083221824 - KELLY HOSNER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Midwife (176B00000X) |
United | 78215 | $259.77 | 1457538225 - SUSAN DREXLER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Specialist (174400000X) |
United | 78215 | $259.77 | 1780976985 - BIRCH DEGOMEZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 78215 | $150.61 | 1124152368 - SCOTT LONGFELLOW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Anesthesiology Physician (207L00000X) |
United | 78215 | $41.40 | 1134318942 - MATTHEW TROESTER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Sleep Medicine (Psychiatry & Neurology) Physician (2084S0012X) |
United | 78215 | $259.77 | 1780987073 - MARIAN LACY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
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 78215 vs. Other Nuclear Medicine Procedures Codes
The CPT 78215 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 78215 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 78215. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78215 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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