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See a sample rate comparisonCPT 78261 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 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.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78261 |
| Medicaid Fee Schedule | View Medicaid rates for 78261 |
National average reimbursement for CPT 78261 by major payers:
$232.35
$252.13
$234.60
$296.63
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CPT 78261
5 of 25 sample ratesHigher to lower in this preview
Robert Sanchez
Radiology Associates Of North Texas, PA
$653.22Published rateAlgimantas Jecius
Northern Arizona Healthcare Corporation
$395.39Published rateWilliam Reese
Radiology Associates Of North Texas, PA
$308.58Published rateAudrey Lee
Northern Arizona Healthcare Corporation
$58.81Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$19.45Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78261 vs. Other Nuclear Medicine Procedures Codes
The CPT 78261 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 78261 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 |
|---|---|---|
| 78258-CPT | Moderate | Study Of Esophagus Function, The Esophagus Function Study (Esophageal Motility) Examines How The Muscle Moves Food From Swallowing To The Stomach. It Can Evaluate The Valves That Stop Acid Reflux As Well As Identify A Problem With Swallowing. |
| 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. |
| 78262-CPT | Moderate | Scan Of Stomach Fluid Reflux, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Fluid Flow On A Scan So That Backward Flow From The Stomach To The Esophagus May Be Viewed More Easily. |
| 78264-CPT | Moderate | Stomach Emptying Study, A Stomach Emptying Study Measures How Fast Food Leaves The Stomach. A Radioactive Substance Is Given To Highlight Areas On The Images. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78261 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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