CPT 78351 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 • GA - Required ABN issued and on file |
| Complexity Level | Low |
National average reimbursement for CPT 78351 by major payers:

$22.90

$24.04

$19.55

$26.74
| 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 78351 | ||||||
United | 78351 | $25.20 | 1730112442 - BARBARA BURGGRAAFF | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Sleep Medicine (Otolaryngology) Physician (207YS0012X) |
United | 78351 | $25.20 | 1376733279 - JULIE MALONEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgical Physician Assistant (363AS0400X) |
United | 78351 | $13.50 | 1295977718 - CHRISTOPHER MUELLER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Cardiovascular Disease Physician (207RC0000X) |
United | 78351 | $25.20 | 1487830907 - LEITH SAWALHA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78351 | $25.20 | 1720036411 - ALICIA HODGE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78351 | $25.20 | 1043718950 - DANIEL HAINLEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Certified Registered Nurse Anesthetist (367500000X) |
United | 78351 | $25.20 | 1740604982 - LAURA MACPHEE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Acute Care Nurse Practitioner (363LA2100X) |
United | 78351 | $13.50 | 1285668624 - ARPANA GUPTA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ND | Internal Medicine Physician (207R00000X) |
United | 78351 | $25.20 | 1508329525 - MEGAN BRENNAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 78351 | $25.20 | 1104147909 - KARAM MOON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurological Surgery Physician (207T00000X) |
United | 78351 | $15.88 | 1952557498 - JEREMY KELLEY | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | 78351 | $13.09 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | 78351 | $13.50 | 1669447488 - BRADLEY NICOL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurological Surgery Physician (207T00000X) |
United | 78351 | $25.20 | 1386649911 - KALPESH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Urology Physician (208800000X) |
United | 78351 | $25.20 | 1477843449 - LU PAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CT | Internal Medicine Physician (207R00000X) |
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 78351 vs. Other Nuclear Medicine Procedures Codes
The CPT 78351 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 78351 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 78351. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78351 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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