CPT 78452 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 78452 by major payers:
$538.29
$595.68
$573.94
$689.19
| 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 78452 | ||||||
United | 78452 | $391.73 | 1346791498 - ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE | 814184298 - (FL) ANSAARIE CARDIAC & ENDOVASCULAR CENTER OF EXCELLENCE, P.A. | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $391.73 | 1144651373 - CARDIAC VISION LLC | 371703159 - (FL) CARDIAC VISION LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $306.66 | 1134127962 - BENJAMIN LLOYD | 264800380 | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $381.82 | 1841242906 - LINUS WODI | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $365.79 | 1447288675 - JULIUS A GASSO M D P A | 650968999 - (FL) JULIUS A GASSO M D P A | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $348.20 | 1538126966 - BRIAN TASCHNER | 262909414 - MILLENNIUM PHYSICIAN GROUP, LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $287.07 | 1831284306 - ROBERT KELSEY | 203273101 - (FL) PRIMECARE PL | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $306.66 | 1295739241 - ISRAEL MANTECON | 205476847 - (FL) CARDIOVASCULAR INSTITUTE OF CENTRAL FLORIDA, LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $326.36 | 1225079668 - HUMBERTO MACHADO | 200665740 - (FL) HUMBERTO C MACHADO JR MD PA | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $498.67 | 1437257292 - GARY SHIFRIN | 592015832 - (FL) CARDIOLOGY ASSOCIATES OF PALM BEACH | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $371.14 | 1053608505 - KONSTANTINOS MARMAGKIOLIS | 921545753 - (FL) TAMPA HEART VASCULAR ASSOCIATES LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $413.67 | 1346361169 - ALMOIS MOHAMAD | 640713033 | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $66.19 | 1053680496 - PAOLA CASANOVA | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $413.35 | 1780679860 - ENRIQUE HUERTAS | 650066685 | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 78452 | $57.81 | 1083606214 - ALBERTO VADILLO | 262424974 | FL | Cardiovascular Disease Physician (207RC0000X) |
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 78452 vs. Other Nuclear Medicine Procedures Codes
The CPT 78452 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 78452 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 |
|---|---|---|
| 78451 | Moderate | Myocardial Perfusion Imaging Tomographic (Spect) (Including Attenuation Correction Qualitative Or Quantitative Wall Motion Ejection Fraction By First Pass Or Gated Technique Additional Quantification When Performed); Single Study At Rest Or Stress (Exercise Or Pharmacologic) |
| 78452 | Moderate | Myocardial Perfusion Imaging Tomographic (Spect) (Including Attenuation Correction Qualitative Or Quantitative Wall Motion Ejection Fraction By First Pass Or Gated Technique Additional Quantification When Performed); Multiple Studies At Rest Or Stress (Exercise Or Pharmacologic) And/Or Redistribution And/Or Rest Reinjection |
| 78453 | Moderate | Myocardial Perfusion Imaging Planar (Including Qualitative Or Quantitative Wall Motion Ejection Fraction By First Pass Or Gated Technique Additional Quantification When Performed); Single Study At Rest Or Stress (Exercise Or Pharmacologic) |
| 78454 | Moderate | Myocardial Perfusion Imaging Planar (Including Qualitative Or Quantitative Wall Motion Ejection Fraction By First Pass Or Gated Technique Additional Quantification When Performed); Multiple Studies At Rest Or Stress (Exercise Or Pharmacologic) And/Or Redistribution And/Or Rest Reinjection |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78452. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78452 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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