CPT 78492 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | High |
| Medicare Fee Schedule | View Medicare rates for 78492 |
National average reimbursement for CPT 78492 by major payers:

$1,012.13

$1,566.04

$1,528.83

$1,275.95
| 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 78492 | ||||||
United | 78492 | $1301.89 | 1386163129 - BRENT DAVIDSON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 78492 | $1480.33 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 78492 | $167.53 | 1871585810 - PHILIP GLEASON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Urology Physician (208800000X) |
United | 78492 | $2225.58 | 1851394142 - DAWN KERSHNER | 464207757 | MD | Cardiovascular Disease Physician (207RC0000X) |
United | 78492 | $160.75 | 1215303110 - BRIAN GRANT | 311118087 | DC | Vascular Surgery Physician (2086S0129X) |
United | 78492 | $731.23 | 1700854288 - LAMB HEALTHCARE CENTER | 752388515 - (TX) LAMB HEALTHCARE CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 78492 | $1312.29 | 1982988655 - SHILO GIFFORD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Medical Physician Assistant (363AM0700X) |
United | 78492 | $1479.82 | 1487034039 - GREGORY DUHON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Internal Medicine Physician (207R00000X) |
United | 78492 | $1479.82 | 1396240800 - ERIN SALTER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Internal Medicine Physician (207R00000X) |
United | 78492 | $1312.29 | 1134325012 - ADAM BOETTCHER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Surgery Physician (208600000X) |
United | 78492 | $167.53 | 1063070175 - EMMA KROLOFF | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Physician Assistant (363A00000X) |
United | 78492 | $1301.89 | 1205013919 - PATRICK MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 78492 | $2137.96 | 1053790998 - SETH MELTZER | 541778418 | VA | Cardiovascular Disease Physician (207RC0000X) |
United | 78492 | $1531.64 | 1952340598 - JOHN PAPPAS | 200400464 | MD | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78492 | $2225.58 | 1124310289 - JEREMY POLLOCK | 464237992 | MD | 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 78492 vs. Other Nuclear Medicine Procedures Codes
The CPT 78492 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 78492 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 | Myocardial Imge Infarct; |
| 78468-CPT | Moderate | Nuclear Medicine Study Of Heart Muscle Following Heart Attack With Measurement Of Internal Blood Volume Ejected With Every Beat |
| 78469-CPT | Moderate | Myocardial Image Infarct; Spect |
| 78492-CPT | High | Myocardial Imaging Positron Emission Tomography (Pet) Perfusion Study (Including Ventricular Wallmotion[S] And/Or Ejection Fraction[S] When Performed); Multiple Studies At Rest And Stress (Exercise Or Pharmacologic) (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78492. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78492 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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