Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 78428 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 Heart Blood Flow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Blood Flow In The Heart On A Scan So That Any Abnormal Passage Between Blood Vessels (Cardiac Shunt) May Be Viewed More Easily.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78428 |
| Medicaid Fee Schedule | View Medicaid rates for 78428 |
National average reimbursement for CPT 78428 by major payers:
$216.76
$210.29
$206.50
$255.44
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 78428.
CPT 78428
5 of 25 sample ratesHigher to lower in this preview
Amy Balis
Radiology Associates Of North Texas, PA
$473.67Published rateMark Bocchicchio
Northern Arizona Healthcare Corporation
$320.41Published rateRajeev Fernando
Northern Arizona Healthcare Corporation
$129.75Published rateClifton Burt
Northern Arizona Healthcare Corporation
$69.01Published rateMazhar Ali
Northern Arizona Healthcare Corporation
$32.83Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 78428 vs. Other Nuclear Medicine Procedures Codes
The CPT 78428 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 78428 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 |
|---|---|---|
| 78414-CPT | Moderate | Heart Blood Flow Study, A Radioactive Substance Is Injected Into The Bloodstream. A Camera Records The Isotopes As They Flow Through One Full Heart Cycle. This Is One Method For Measuring The Physical Forces That Influence Blood Flow. |
| 78428-CPT | Moderate | Scan Of Heart Blood Flow, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Blood Flow In The Heart On A Scan So That Any Abnormal Passage Between Blood Vessels (Cardiac Shunt) May Be Viewed More Easily. |
| 78429-CPT | Moderate | Myocrd Img Pet 1 Std W Ct, Myocardial Imaging Positron Emission Tomography Pet Metabolic Evaluation Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Single Study With Concurrently Acquired Computed Tomography Transmission Scan |
| 78430-CPT | Moderate | Myocrd Img Pet Rst Strs W Ct, Myocardial Imaging Positron Emission Tomography Pet Perfusion Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Single Study At Rest Or Stress Exercise Or Pharmacologic With Concurrently Acquired Computed Tomography Transmission Scan |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78428 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 78428) and we'll show you how you compare in 15 minutes or less.