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CPT 78499 Fee Schedule

Last Verified: December 2025

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.

Unlisted Cardiovascular Procedure, Diagnostic Nuclear Medicine
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 78499 by major payers:

bcbs

$1,508.77

uhc

$479.97

aetna

$173.94

cigna

$695.81

Preview provider-level rates for...
For billing codeCPT 78499
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 78499

United
78499$785.941093774762 - STEVENS COUNTY HOSPITAL481009034 - (KS) STEVENS COUNTY HOSPITALKSCritical Access Hospital (282NC0060X)
United
78499$552.201275583726 - CAPITAL HEALTH SYSTEM INC, REGIONAL MEDICAL CENTER223548695 - (NJ) CAPITAL HEALTH SYSTEM INCNJGeneral Acute Care Hospital (282N00000X)
United
78499$625.821467109488 - MOUNTAIN VISTA MEDICAL CENTER, LP202066363 - (AZ) MOUNTAIN VISTA MEDICAL CENTER LPAZGeneral Acute Care Hospital (282N00000X)
United
78499$576.981720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN742781812TXGeneral Acute Care Hospital (282N00000X)
United
78499$336.761235109778 - COMMUNITY HOSPITAL SOUTH, INC., COMMUNITY HOSPITAL SOUTH351088640 - COMMUNITY HOSPITALS OF INDIANA INCINGeneral Acute Care Hospital (282N00000X)
United
78499$386.541508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION430687077 - (MO) MERCY HOSPITAL JEFFERSONMOGeneral Acute Care Hospital (282N00000X)
United
78499$339.411083286801 - STEWARD CGH, INC.650638215FLGeneral Acute Care Hospital (282N00000X)
United
78499$250.161548750417 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS830516935KSGeneral Acute Care Hospital (282N00000X)
United
78499$699.611487607784 - NORTHWEST HOSPITAL LLC, NORTHWEST MEDICAL CENTER621762430AZGeneral Acute Care Hospital (282N00000X)
United
78499$552.201275583726 - CAPITAL HEALTH SYSTEM INC, REGIONAL MEDICAL CENTER223548695 - (NJ) CAPITAL HEALTH SYSTEM INCNJGeneral Acute Care Hospital (282N00000X)
United
78499$250.161548750417 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS830516935KSGeneral Acute Care Hospital (282N00000X)
United
78499$625.821609345685 - MOUNTAIN VISTA MEDICAL CENTER, LP, FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER202066363 - (AZ) MOUNTAIN VISTA MEDICAL CENTER LPAZGeneral Acute Care Hospital (282N00000X)
United
78499$594.041275511651 - ADVENTIST HEALTH SYSTEM-SUNBELT INC, ADVENTHEALTH LAB590725553 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INCFLCritical Access Hospital (282NC0060X)
United
78499$866.221427048453 - MEDINA COUNTY HOSPITAL DISTRICT, MEDINA REGIONAL HOSPITAL270492434TXCritical Access Hospital (282NC0060X)
United
78499$783.711770598104 - KENMORE MERCY HOSPITAL160762843 - (NY) KENMORE MERCY HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
78466-CPTModerateMyocardial Imge Infarct;
78468-CPTModerateNuclear Medicine Study Of Heart Muscle Following Heart Attack With Measurement Of Internal Blood Volume Ejected With Every Beat
78469-CPTModerateMyocardial Image Infarct; Spect
78499-CPTHighUnlisted Cardiovascular Procedure, Diagnostic Nuclear Medicine

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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