CPT 78458 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 78458 by major payers:
$243.73
$235.33
$220.48
$291.72
| 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 78458 | ||||||
United | 78458 | $76.80 | 1972245140 - BENJAMIN CARLOS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 78458 | $97.44 | 1801884606 - JAMES LOWE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78458 | $76.80 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | LA | Internal Medicine Physician (207R00000X) |
United | 78458 | $140.80 | 1710324181 - MANMEET BEDI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 78458 | $76.80 | 1073352795 - KATIE MOORE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Midwife (176B00000X) |
United | 78458 | $140.80 | 1508829912 - ALGIMANTAS JECIUS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgery Physician (208600000X) |
United | 78458 | $627.10 | 1285370551 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 78458 | $76.80 | 1922379023 - BOCEIFUS MEDLIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 78458 | $265.19 | 1053563965 - RAYMOND LIEBER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 78458 | $39.24 | 1285405514 - JOSEPH LACH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Family Nurse Practitioner (363LF0000X) |
United | 78458 | $97.44 | 1396722518 - THOMAS MCGEE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78458 | $265.19 | 1407920952 - JEFFREY WILLIAMS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | LA | Plastic Surgery Physician (208200000X) |
United | 78458 | $76.80 | 1851759724 - AARON SHAW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Surgical Physician Assistant (363AS0400X) |
United | 78458 | $39.58 | 1215706767 - PATRICK KINSELLA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine Registered Nurse (163WC0200X) |
United | 78458 | $140.80 | 1467914291 - DANIEL MERRILL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Pediatrics Physician (208000000X) |
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 78458 vs. Other Nuclear Medicine Procedures Codes
The CPT 78458 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 78458 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 |
| 78458-CPT | Moderate | Venous Thrombosis Imag; Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78458. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78458 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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