CPT 78481 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 • TC - Technical component • 26 - Professional component |
| Complexity Level | Moderate |
National average reimbursement for CPT 78481 by major payers:
$211.60
$225.63
$200.80
$272.88
| 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 78481 | ||||||
United | 78481 | $492.05 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 78481 | $345.53 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 78481 | $252.25 | 1871835181 - JOHN KIM | 43320571 | MA | Internal Medicine Physician (207R00000X) |
United | 78481 | $40.79 | 1699069898 - SEPEHR MESDAGHINIA | 822260093 - (VA) NOVA ARTHRITIS AND RHEUMATOLOGY SPECIALISTS LLC | VA | Rheumatology Physician (207RR0500X) |
United | 78481 | $157.05 | 1346649886 - VINEYARD MEDICAL CARE LLC | 471552938 - (MA) VINEYARD MEDICAL CARE LLC | MA | Internal Medicine Physician (207R00000X) |
United | 78481 | $307.66 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | 78481 | $178.60 | 1669467684 - DAVID MILLER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 78481 | $142.96 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 78481 | $113.04 | 1871191361 - BATTLE BORN BRAIN AND SPINE PLLC | 853177121 - (NV) BATTLE BORN BRAIN AND SPINE PLLC | NV | Neurological Surgery Physician (207T00000X) |
United | 78481 | $93.36 | 1568669646 - NAHIDA ISLAM | 42472266 - (MA) RELIANT MEDICAL GROUP, INC. | MA | Hematology & Oncology Physician (207RH0003X) |
United | 78481 | $61.71 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 78481 | $38.25 | 1619169810 - MEDICAL CONSULTANTS OF FLORIDA, LLC, MEDFLORIDA MEDICAL CENTER | 352305118 - MEDICAL CONSULTANTS OF PALM BEACH, LLC | FL | Internal Medicine Physician (207R00000X) |
United | 78481 | $286.00 | 1629180658 - FLORANCE HYPPOLITE | 630545981 - (AL) PEDIATRIC CLINIC LLC | AL | Pediatrics Physician (208000000X) |
United | 78481 | $132.08 | 1295825784 - YEN NIEMAN | 742631566 - (TX) TEXAN EYE, P.A. | TX | Ophthalmology Physician (207W00000X) |
United | 78481 | $41.08 | 1326246638 - JACINTO MANON | 823277834 - (CO) JM NEUROSPINE LLC | TX | Neurological Surgery Physician (207T00000X) |
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 78481 vs. Other Nuclear Medicine Procedures Codes
The CPT 78481 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 78481 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 |
|---|---|---|
| 78472-CPT | Moderate | Cardiac Blood Pool Imaging, Gated Equilibrium; Planar, Single Study At Rest Or Stress (Exercise And/Or Pharmacologic), Wall Motion Study Plus Ejection Fraction, With Or Without Additional Quantitative Processing |
| 78473-CPT | Moderate | Cardiac Blood Pool Imaging, Gated Equilibrium; Multiple Studies, Wall Motion Study Plus Ejection Fraction, At Rest And Stress (Exercise And/Or Pharmacologic), With Or Without Additional Quantification |
| 78481-CPT | Moderate | Cardiac Blood Pool Imaging (Planar), First Pass Technique; Single Study, At Rest Or With Stress (Exercise And/Or Pharmacologic), Wall Motion Study Plus Ejection Fraction, With Or Without Quantification |
| 78483-CPT | Moderate | Cardiac Blood Pool Imaging (Planar), First Pass Technique; Multiple Studies, At Rest And With Stress (Exercise And/Or Pharmacologic), Wall Motion Study Plus Ejection Fraction, With Or Without Quantification |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78481. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78481 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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