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See a sample rate comparisonCPT 78499 Fee Schedule
CPT 78499 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Scan Of The Heart, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Heart Structure And Function On A Scan So That It May Be Viewed More Easily.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78499 |
| Medicaid Fee Schedule | View Medicaid rates for 78499 |
National average reimbursement for CPT 78499 by major payers:
$1,508.77
BCBS / Anthem
$479.97
UnitedHealthcare
$173.94
Aetna
$772.86
Cigna
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CPT 78499
5 of 25 sample ratesHigher to lower in this preview
Inova Health Care Services, Inova Fairfax Hospital
Inova Health Care Services
$1,058.71Published rateNorthwest Hospital LLC, Northwest Medical Center
$699.61Published ratePrime Healthcare Services, St. Mary'S Hospital
$565.67Published rateLehigh Hma LLC, Lehigh Regional Medical Center
$441.76Published rateUkhs Great Bend, LLC, The University Of Kansas Health System Great Bend Campus
$250.16Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78499 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78499. Select one to see its fee schedule.
| 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. |
| 78499-CPT | High | Scan Of The Heart, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights The Heart Structure And Function On A Scan So That It May Be Viewed More Easily. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78499 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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