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See a sample rate comparisonCPT 78290 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 Intestines, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Intestines So That The Area May Be Seen 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 TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78290 |
| Medicaid Fee Schedule | View Medicaid rates for 78290 |
National average reimbursement for CPT 78290 by major payers:
$373.33
$356.76
$360.89
$436.98
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CPT 78290
5 of 25 sample ratesHigher to lower in this preview
Health Imaging Partners, LLC
$1,018.27Published rateBenjamin Wilson
Radiology Associates Of North Texas, PA
$791.30Published rateStephen Peters
Northern Arizona Healthcare Corporation
$423.60Published rateDavid Riepe
Radiology Associates Of North Texas, PA
$260.75Published rateSamantha Elsbree
Northern Arizona Healthcare Corporation
$28.84Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78290 vs. Other Nuclear Medicine Procedures Codes
The CPT 78290 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 78290 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 |
|---|---|---|
| 78278-CPT | Moderate | Imaging For Digestive Bleeding, During A Scan Of The Stomach And Intestines A Radioactive Substance Is Given By Mouth Or Into A Vein. The Substance Highlights Areas Of The Stomach And Intestine On Images. |
| 78282-CPT | Moderate | Exam Of Stool For Protein, A Radioactive Material Is Injected Into A Vein And Subsequent Stool Samples Are Collected. The Test Measures The Amount Of Protein That Is Not Properly Absorbed Through The Intestinal Tract. |
| 78290-CPT | Moderate | Scan Of Intestines, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Intestines So That The Area May Be Seen More Easily. |
| 78291-CPT | Moderate | Check Flow Through Shunt, A Radioactive Substance Is Given By Mouth Or Iv To Highlight A Passage (Shunt) Connecting A Blood Vessel To The Abdominal Cavity. The Area Is Scanned To View How Well Fluid Is Moving Through The Shunt. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78290. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78290 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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