CPT 78494 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 TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78494 |
National average reimbursement for CPT 78494 by major payers:
$273.28
$288.44
$264.54
$338.47
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 78494 | $590.08 | 1407146384 - RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78494 | $426.04 | 1346211810 - JAMES YAQUINTO | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78494 | $471.58 | 1851735856 - TIFFANY YNOSENCIO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 78494 | $590.08 | 1063478071 - KEVIN MCCRARY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78494 | $198.47 | 1124152368 - SCOTT LONGFELLOW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Anesthesiology Physician (207L00000X) |
United | 78494 | $73.76 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 78494 | $55.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 78494 | $81.96 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 78494 | $148.88 | 1881655843 - KEVIN SHORT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78494 | $50.61 | 1588744270 - MICHAEL MACDONALD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Urology Physician (208800000X) |
United | 78494 | $590.08 | 1568521680 - RADIOLOGY ASSOCIATES OF NORTH TEXAS PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78494 | $366.57 | 1053480095 - MICHAEL RAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 78494 | $70.54 | 1821081720 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 78494 | $441.20 | 1033552005 - SHOEB CHAUDRY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78494 | $105.01 | 1710177084 - GREGORY FORD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Anesthesiology Physician (207L00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 78494 vs. Other Nuclear Medicine Procedures Codes
The CPT 78494 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 78494 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 78494. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78494 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 78494) and we'll show you how you compare in 15 minutes or less.