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See a sample rate comparisonCPT 78231 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 Saliva Gland Function, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Saliva Glands On A Scan So That Their Function May Be Viewed More Easily. Multiple Images May Be Taken.
| 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 78231 |
| Medicaid Fee Schedule | View Medicaid rates for 78231 |
National average reimbursement for CPT 78231 by major payers:
$135.83
$138.52
$130.19
$164.74
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CPT 78231
5 of 25 sample ratesHigher to lower in this preview
Richard Murray
Radiology Associates Of North Texas, PA
$341.95Published rateJessica Fletcher
Northern Arizona Healthcare Corporation
$176.38Published rateChristopher Raio
Mercy Medical Center
$130.43Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$52.25Published rateHannah Fox
Northern Arizona Healthcare Corporation
$19.02Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78231 vs. Other Nuclear Medicine Procedures Codes
The CPT 78231 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 78231 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 |
|---|---|---|
| 78230-CPT | Moderate | Scan Of Saliva Gland Function, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Saliva Glands On A Scan So That Their Function May Be Viewed More Easily. Multiple Images May Be Taken. |
| 78231-CPT | Low | Scan Of Saliva Gland Function, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Saliva Glands On A Scan So That Their Function May Be Viewed More Easily. Multiple Images May Be Taken. |
| 78232-CPT | Low | Scan Of Saliva Gland Function, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Saliva Fluid On A Scan So That It May Be Viewed As It Flows From The Mouth To The Stomach. |
| 78261-CPT | Moderate | Scan Of Stomach Lining, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Stomach Lining On A Scan So That It May Be Viewed More Easily. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78231. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78231 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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