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 |
| Medicare Fee Schedule | View Medicare rates for 78429 |
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 | 1922413285 - STEVEN NUANES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Internal Medicine Physician (207R00000X) |
United | 78429 | $142.19 | 1043240609 - KIMBERLY SARGENT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 78429 | $166.30 | 1487997706 - SOHAIB KAYANI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Obstetrics & Gynecology Physician (207V00000X) |
United | 78429 | $251.91 | 1245420348 - PARAG SHAH | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | MA | Diagnostic Radiology Physician (2085R0202X) |
United | 78429 | $38.06 | 1851450969 - RADIOLOGY ASSOCIATES OF NORTH TEXAS PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78429 | $213.85 | 1043578925 - ALEXANDER KELLEY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | VA | Diagnostic Radiology Physician (2085R0202X) |
United | 78429 | $142.19 | 1487830907 - LEITH SAWALHA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78429 | $24.11 | 1851824163 - MATTHEW STUART | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MN | Internal Medicine Physician (207R00000X) |
United | 78429 | $1299.13 | 1609950500 - MICHAEL REIDY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MT | Pulmonary Disease Physician (207RP1001X) |
United | 78429 | $142.19 | 1548647472 - SEAN LARSEN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 78429 | $1648.20 | 1912620980 - NIDHI MEHTA | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 78429 | $38.06 | 1992043517 - MARY FIESTA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Adult Health Nurse Practitioner (363LA2200X) |
United | 78429 | $142.19 | 1235225780 - CLAUDE FORTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IL | Neurology Physician (2084N0400X) |
United | 78429 | $166.30 | 1932137486 - DUANE LAMBERT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 78429 | $38.06 | 1467985986 - MOHAMMAD IBRAHIM | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | CO | Diagnostic Radiology Physician (2085R0202X) |
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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