CPT 78429 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 |
National average reimbursement for CPT 78429 by major payers:
$782.27
$924.60
$1,466.99
$1,760.70
| 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 78429 | ||||||
United | 78429 | $142.19 | 1356381719 - DAVID ZABEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Plastic Surgery Physician (208200000X) |
United | 78429 | $251.91 | 1417303405 - MARK WINTER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 78429 | $12.31 | 1891781720 - MARGARET KOZAK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NJ | Family Medicine Physician (207Q00000X) |
United | 78429 | $166.30 | 1003303611 - JENNA PLUMMER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MA | Physical Therapist (225100000X) |
United | 78429 | $166.30 | 1710543889 - COREY WARNER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | UT | Certified Registered Nurse Anesthetist (367500000X) |
United | 78429 | $24.11 | 1659670115 - JESSICA REED | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Acute Care Nurse Practitioner (363LA2100X) |
United | 78429 | $72.69 | 1124510201 - ALEXANDER PECKHAM | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | HI | Internal Medicine Physician (207R00000X) |
United | 78429 | $1226.43 | 1477843449 - LU PAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78429 | $84.91 | 1023438009 - MOLLY MCINTOSH | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Home Health Agency (251E00000X) |
United | 78429 | $24.11 | 1225094485 - JOEL HAHNKE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Pediatrics Physician (208000000X) |
United | 78429 | $213.85 | 1710416003 - MOHAMMED ALAM | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78429 | $213.85 | 1033552005 - SHOEB CHAUDRY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78429 | $166.30 | 1720027337 - DEBORAH LINDQUIST | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hematology & Oncology Physician (207RH0003X) |
United | 78429 | $166.30 | 1841452737 - SALLY MCFARLANE-PARROTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Anesthesiology Physician (207L00000X) |
United | 78429 | $166.30 | 1255449500 - EDWARD CAMPBELL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Anesthesiology Physician (207L00000X) |
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 78429 vs. Other Nuclear Medicine Procedures Codes
The CPT 78429 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 78429 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 | Determination Of Central C-V Hemodynamics (Non-Imaging) (Eg, Ejection Fraction With Probe Technique) With Or Without Pharmacologic Intervention Or Exercise, Single Or Multiple Determinations |
| 78428-CPT | Moderate | Cardiac Shunt Detection |
| 78429-CPT | Moderate | 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 | 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 78429. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78429 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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