CPT 78456 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 • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 78456 by major payers:
$352.55
$358.46
$329.11
$444.52
| 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 78456 | ||||||
United | 78456 | $569.40 | 1235494709 - CHARLES CLUFF | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 78456 | $705.57 | 1891104550 - JOSHUA CARLTON | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78456 | $705.57 | 1285926659 - JUSTIN SACKS | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78456 | $705.57 | 1720840218 - JARED JACQUES | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 78456 | $90.00 | 1780987073 - MARIAN LACY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 78456 | $124.51 | 1043795347 - BRIAN HONEKAMP | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Nurse Practitioner (363L00000X) |
United | 78456 | $331.44 | 1154300283 - STUART ARONSON | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78456 | $479.39 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Internal Medicine Physician (207R00000X) |
United | 78456 | $124.51 | 1699204081 - KEVIN HOANG | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78456 | $228.53 | 1720195217 - CLAUDIA CAMACHO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 78456 | $569.40 | 1932165636 - STEVEN MCCANN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Obstetrics & Gynecology Physician (207V00000X) |
United | 78456 | $90.00 | 1023086758 - NINA SOUDERS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 78456 | $479.39 | 1356345383 - EUGENE CHARLEBOIS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Emergency Medicine Physician (207P00000X) |
United | 78456 | $124.51 | 1003877069 - R. WALKER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78456 | $569.40 | 1699739862 - JONATHAN WEISER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Family Medicine Physician (207Q00000X) |
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 78456 vs. Other Nuclear Medicine Procedures Codes
The CPT 78456 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 78456 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-CPT | 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-CPT | 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 |
| 78454-CPT | 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 |
| 78456-CPT | Moderate | Acute Venous Thrombosis Imaging, Peptide |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78456. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78456 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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