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See a sample rate comparisonCPT 78499 Fee Schedule
Last Verified: September 2026
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.
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 | None 26 - Professional component TC - Technical component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78499 |
National average reimbursement for CPT 78499 by major payers:
$1,508.77
$479.97
$173.94
$772.86
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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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See a sample payer proposalCPT 78499 vs. Other Nuclear Medicine Procedures Codes
The CPT 78499 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 78499 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. |
| 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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