CPT 78579 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78579 |
National average reimbursement for CPT 78579 by major payers:

$210.77

$218.78

$206.12

$281.62
| 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 78579 | ||||||
United | 78579 | $20.86 | 1205013919 - PATRICK MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 78579 | $256.95 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 78579 | $29.06 | 1235122029 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 78579 | $136.41 | 1649641135 - CLAIRE VELTKAMP | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Family Nurse Practitioner (363LF0000X) |
United | 78579 | $266.98 | 1477843449 - LU PAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Internal Medicine Physician (207R00000X) |
United | 78579 | $40.81 | 1790449650 - JACQUELYN POVILAITIS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 78579 | $266.98 | 1649351222 - RAVINDRA GUDAVALLI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IA | Pulmonary Disease Physician (207RP1001X) |
United | 78579 | $307.79 | 1003910209 - ANDRZEJ KUDELKA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Medical Oncology Physician (207RX0202X) |
United | 78579 | $430.39 | 1578564118 - CHRISTOPHER MCMILLAN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78579 | $20.86 | 1295490696 - THOMAS DE MOULIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 78579 | $136.41 | 1568870988 - MEGAN ALATORRE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 78579 | $164.41 | 1659516169 - JESSICA COURTNEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Certified Registered Nurse Anesthetist (367500000X) |
United | 78579 | $164.41 | 1154378164 - HASSAN SHAFEEQ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78579 | $71.30 | 1265762470 - HEALTH IMAGING PARTNERS LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 78579 | $307.79 | 1528350139 - BRANDON ABBOTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Hospitalist Physician (208M00000X) |
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 78579 vs. Other Nuclear Medicine Procedures Codes
The CPT 78579 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 78579 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 |
|---|---|---|
| 78579-CPT | Moderate | Pulmonary Ventilation Imaging (Eg, Aerosol Or Gas) |
| 78580-CPT | Moderate | Nuclear Medicine Study Of Blood Circulation In The Lungs |
| 78582-CPT | Moderate | Pulmonary Ventilation (Eg Aerosol Or Gas) And Perfusion Imaging (Reinstated Code Former Description Was: Nuclear Scan Of Lung;Gaseous With Ventilation Rebreathing And Washout) |
| 78597-CPT | Moderate | Quantitative Differential Pulmonary Perfusion, Including Imaging When Performed. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78579. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78579 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 78579) and we'll show you how you compare in 15 minutes or less.
