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See a sample rate comparisonCPT 78265 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $347.70 national non-facility rate (2026) · View Medicare rates for 78265 |
| Medicaid Fee Schedule | $289.965 median of the 8 states in the free preview · View Medicaid rates for 78265 |
National average reimbursement for CPT 78265 by major payers:

$433.40
BCBS / Anthem

$470.22
UnitedHealthcare

$419.90
Aetna

$567.76
Cigna
Choose a payer to see a sample of rates for CPT 78265.
Emily Andrisevic
Northern Arizona Healthcare Corporation
Melanie Nugent
Northern Arizona Healthcare Corporation
Childrens National Medical Center
Childrens Hospital
Matthew Horn
Northern Arizona Healthcare Corporation
Kristy Ingebo
Northern Arizona Healthcare Corporation
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 78265 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78265. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 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. |
| 78265-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. |
| 78266-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 78265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78265 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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