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See a sample rate comparisonCPT 78268 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.
Urea Breath Test, During The Urea Breath Test A Tablet Containing Urea Is Swallowed. Then A Breath Sample Is Obtained And Measured. The Test Detects A Type Of Bacteria That Infects The Stomach And Is A Main Cause Of Ulcers.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service U7 |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78268 |
| Medicaid Fee Schedule | View Medicaid rates for 78268 |
National average reimbursement for CPT 78268 by major payers:
$121.02
$56.24
$107.73
$157.59
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CPT 78268
5 of 25 sample ratesHigher to lower in this preview
Orthopedic Hospital Ltd, Texas Orthopedic Hospital
Orthopedic Hospital Ltd
$179.38Published rateGamaliel Rodriguez-Herrera
$123.68Published rateLamb Healthcare Center
$94.11Published rateFrank Kosarek
Spectrum Healthcare Partners, P.A.
$47.20Published rateChristus Spohn Health System Corporation, Christus Spohn Hospital Kleberg
C H Wilkinson Physician Network
$16.57Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78268 vs. Other Nuclear Medicine Procedures Codes
The CPT 78268 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 78268 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 |
|---|---|---|
| 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. |
| 78267-CPT | Low | Urea Breath Test, During The Urea Breath Test A Tablet Containing Urea Is Swallowed. Then A Breath Sample Is Obtained And Measured. The Test Detects A Type Of Bacteria That Infects The Stomach And Is A Main Cause Of Ulcers. |
| 78268-CPT | Low | Urea Breath Test, During The Urea Breath Test A Tablet Containing Urea Is Swallowed. Then A Breath Sample Is Obtained And Measured. The Test Detects A Type Of Bacteria That Infects The Stomach And Is A Main Cause Of Ulcers. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78268. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78268 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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