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See a sample rate comparisonCPT 78226 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 Bile System, A Scan Of The Bile Ducts Including The Liver And Gall Bladder. Medication May Be Given During The Procedure.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78226 |
| Medicaid Fee Schedule | View Medicaid rates for 78226 |
National average reimbursement for CPT 78226 by major payers:
$362.72
$391.71
$394.53
$474.95
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CPT 78226
5 of 25 sample ratesHigher to lower in this preview
Shilo Gifford
Northern Arizona Healthcare Corporation
$579.00Published rateS Faulkner
Northern Arizona Healthcare Corporation
$579.00Published rateSusan Wall
Northern Arizona Healthcare Corporation
$492.98Published rateClaudia Camacho
Northern Arizona Healthcare Corporation
$256.14Published rateWilliam Utz
Northern Arizona Healthcare Corporation
$31.59Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78226 vs. Other Nuclear Medicine Procedures Codes
The CPT 78226 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 78226 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. |
| 78226-CPT | Moderate | Scan Of Bile System, A Scan Of The Bile Ducts Including The Liver And Gall Bladder. Medication May Be Given During The Procedure. |
| 78227-CPT | Moderate | Hepatobil Syst Image W Drug, Hepatobiliary System Imaging Including Gallbladder When Present With Pharmacologic Intervention Including Quantitative Measurement S When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78226. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78226 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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