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See a sample rate comparisonCPT 78216 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.
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.
| 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 GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78216 |
| Medicaid Fee Schedule | View Medicaid rates for 78216 |
National average reimbursement for CPT 78216 by major payers:
$166.78
$156.30
$147.33
$191.18
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CPT 78216
5 of 25 sample ratesHigher to lower in this preview
Brent Morrow
Northern Arizona Healthcare Corporation
$181.19Published rateJacquelyn Povilaitis
Northern Arizona Healthcare Corporation
$181.19Published rateAaron Schnell
Northern Arizona Healthcare Corporation
$113.19Published rateKatherine Ford
Northern Arizona Healthcare Corporation
$47.99Published rateGregory Linderer
Northern Arizona Healthcare Corporation
$23.62Published rate
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See a sample payer proposalCPT 78216 vs. Other Nuclear Medicine Procedures Codes
The CPT 78216 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 78216 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 |
|---|---|---|
| 78201-CPT | Moderate | Scan Of Liver, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Liver Tissue On A Scan So That It May Be Viewed More Easily. Blood Flow Through The Organ May Also Be Viewed. |
| 78202-CPT | Moderate | Scan Of Liver, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Liver Tissue On A Scan So That It May Be Viewed More Easily. Blood Flow Through The Organ May Also Be Viewed. |
| 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. |
| 78216-CPT | Low | 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 78216. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78216 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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