CPT 78433 Fee Schedule
Healthcare 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 |
National average reimbursement for CPT 78433 by major payers:
$1,158.83
$3,107.76
$1,636.38
$2,757.69
| 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 78433 | ||||||
United | 78433 | $2337.83 | 1063415982 - JOHN DEMARINO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | VA | Anesthesiology Physician (207L00000X) |
United | 78433 | $4758.62 | 1275626939 - IAN LIVINGSTONE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 78433 | $2431.38 | 1285905315 - DANA GARNER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Adult Health Nurse Practitioner (363LA2200X) |
United | 78433 | $182.99 | 1003268749 - ELIZABETH GILMORE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 78433 | $2431.38 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Neurology Physician (2084N0400X) |
United | 78433 | $93.55 | 1588744270 - MICHAEL MACDONALD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Urology Physician (208800000X) |
United | 78433 | $93.50 | 1013092543 - KIM CARLTON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Medical Physician Assistant (363AM0700X) |
United | 78433 | $4758.62 | 1477993103 - MAGDY HANNA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Cardiovascular Disease Physician (207RC0000X) |
United | 78433 | $3099.83 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 78433 | $182.99 | 1891026381 - NANCY UDALL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NC | Certified Registered Nurse Anesthetist (367500000X) |
United | 78433 | $4575.64 | 1689673972 - TAMARAH FRATIANNI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Facial Plastic Surgery Physician (207YS0123X) |
United | 78433 | $4575.64 | 1245882372 - SAMUEL MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NE | Hospitalist Physician (208M00000X) |
United | 78433 | $4575.64 | 1104875186 - WILLIAM UTZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MN | Urology Physician (208800000X) |
United | 78433 | $93.55 | 1730543067 - JORDAN SELZER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NV | Emergency Medicine Physician (207P00000X) |
United | 78433 | $182.99 | 1114289105 - ANNA TORGESON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MD | Radiation Oncology Physician (2085R0001X) |
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 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 | 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 |
| 78431-CPT | High | 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 | 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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