CPT 78305 Fee Schedule
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.
| 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 • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78305 |
National average reimbursement for CPT 78305 by major payers:

$298.83

$293.59

$287.88

$366.43
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 78305 | ||||||
United | 78305 | $358.82 | 1902836943 - DLP CENTRAL CAROLINA MEDICAL CENTER LLC, CENTRAL CAROLINA HOSPITAL | 810691912 | NC | General Acute Care Hospital (282N00000X) |
United | 78305 | $866.22 | 1053316844 - VIRTUA WILLINGBORO HOSPITAL INC, VIRTUA HEALTH & WELLNESS CENTER | 223612265 - (NJ) VIRTUA WILLINGBORO HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78305 | $920.33 | 1528027240 - FAYETTE COMMUNITY HOSPITAL, INC., PIEDMONT FAYETTE HOSPITAL | 582322328 - (GA) FAYETTE COMMUNITY HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 78305 | $648.91 | 1417957473 - ELADH, LP, EAST LOS ANGELES DOCTORS HOSPITAL | 760594559 - (CA) EAST L A DOCTORS HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | 78305 | $207.97 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | 78305 | $377.11 | 1326022765 - VHS OF ARROWHEAD, INC, ABRAZO ARROWHEAD CAMPUS | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 78305 | $866.22 | 1881691061 - GRAHAM HOSPITAL DISTRICT, GRAHAM REGIONAL MEDICAL CENTER | 463113489 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 78305 | $41.68 | 1700458296 - WENTZVILLE IMAGING CENTER, LLC | 863123352 - (MO) WENTZVILLE IMAGING CENTER LLC | MO | Radiology Clinic/Center (261QR0200X) |
United | 78305 | $168.69 | 1609884238 - F. DANIEL JACKSON, MD, PA T/A THE IMAGING CENTER | 521694585 - (MD) F. DANIEL JACKSON, M.D., P.A. T/A THE IMAGING CENTER | MD | Radiology Clinic/Center (261QR0200X) |
United | 78305 | $339.41 | 1497327233 - STEWARD PGH, INC. | 862724926 | FL | General Acute Care Hospital (282N00000X) |
United | 78305 | $377.11 | 1114473329 - EMERUS BHS SA THOUSAND OAKS LLC, BAPTIST NEIGHBORHOOD HOSPITAL SHAVANO PARK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 78305 | $377.11 | 1154618742 - VHS HARLINGEN HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 78305 | $377.11 | 1396745832 - ARIZONA SPINE AND JOINT HOSPITAL LLC | 364399746 - (AZ) ARIZONA SPINE AND JOINT HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 78305 | $736.26 | 1407313760 - HH HEALTH SYSTEM, MARSHALL MEDICAL CENTER | 831651180 | AL | General Acute Care Hospital (282N00000X) |
United | 78305 | $754.23 | 1902805062 - GREATER REGIONAL MEDICAL CENTER | 426037626 - (IA) GREATER REGIONAL MEDICAL CENTER | IA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 78305 vs. Other Nuclear Medicine Procedures Codes
The CPT 78305 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 78305 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78305 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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