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See a sample rate comparisonCPT 78468 Fee Schedule
Last Verified: September 2026
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.
Heart Scan After Heart Attack, A Radioactive Substance Is Injected And Its Movement Through The Heart Is Recorded By A High-Energy Camera For Several Heart Cycles. The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury.
| 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 XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78468 |
| Medicaid Fee Schedule | View Medicaid rates for 78468 |
National average reimbursement for CPT 78468 by major payers:
$227.64
$231.76
$212.31
$278.50
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CPT 78468
5 of 25 sample ratesHigher to lower in this preview
Vernon Williams
Radiology Associates Of North Texas, PA
$519.70Published rateKenneth Veiga
Northern Arizona Healthcare Corporation
$372.58Published rateChristopher Raio
Mercy Medical Center
$238.39Published rateGregory Duhon
Northern Arizona Healthcare Corporation
$72.00Published rateMazhar Ali
Northern Arizona Healthcare Corporation
$33.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78468 vs. Other Nuclear Medicine Procedures Codes
The CPT 78468 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 78468 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 |
|---|---|---|
| 78466-CPT | Moderate | Heart Scan After Heart Attack, A Radioactive Substance Is Injected And Its Movement Through The Heart Is Recorded By A High-Energy Camera For Several Heart Cycles. The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury. |
| 78468-CPT | Moderate | Heart Scan After Heart Attack, A Radioactive Substance Is Injected And Its Movement Through The Heart Is Recorded By A High-Energy Camera For Several Heart Cycles. The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury. |
| 78469-CPT | Moderate | 3d Ct Scan Of Heart For Injury, A True 3-D Scan Of The Heart Uses A High-Energy Ct (Computed Tomography) Scanner (Spect). The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury After A Heart Attack. |
| 78494-CPT | Moderate | 3-D Ct Scan Heart Blood Flow, A True 3-D Scan Of The Heart Uses A High-Energy Ct (Computed Tomography) Scanner (Spect). Images Are Taken After Giving A Radioactive Substance By Mouth Or Iv To Highlight Blood Flow. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78468. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78468 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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