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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component MG - The order for this service does not have appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78433 |
| Medicaid Fee Schedule | View Medicaid rates for 78433 |
National average reimbursement for CPT 78433 by major payers:

$1,158.83

$3,107.76

$1,636.38

$2,599.36
Choose a payer to see a sample of rates for CPT 78433.
Radiology Associates Of North Texas, PA
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 78433 vs. Other Nuclear Medicine Procedures Codes
The CPT 78433 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 78433 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 |
|---|---|---|
| 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 |
| 78431-CPT | High | Myocrd Img Pet Rst Strs Ct, Myocardial Imaging Positron Emission Tomography Pet Perfusion Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Multiple Studies At Rest And Stress Exercise Or Pharmacologic With Concurrently Acquired Computed Tomography Transmission Scan |
| 78433-CPT | High | Myocrd Img Pet 2rtracer Ct, Myocardial Imaging Positron Emission Tomography Pet Combined Perfusion With Metabolic Evaluation Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Dual Radiotracer Eg Myocardial Viability 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 78433. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78433 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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