CPT 78598 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78598 |
National average reimbursement for CPT 78598 by major payers:
$335.67
$362.40
$350.22
$454.26
| 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 78598 | ||||||
United | 78598 | $532.79 | 1871084889 - BRITTANY ARCARIS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 78598 | $69.01 | 1588192363 - NICOLE CHIEKA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Gerontology Nurse Practitioner (363LG0600X) |
United | 78598 | $236.97 | 1780941286 - MEGHAN HUGHES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Family Medicine Physician (207Q00000X) |
United | 78598 | $532.79 | 1154378164 - HASSAN SHAFEEQ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 78598 | $35.58 | 1699233676 - CHAD MOODY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 78598 | $69.01 | 1942615778 - BRYAN BARKER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 78598 | $35.58 | 1528065919 - DAVID VAN DE WYNGAERDE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 78598 | $532.79 | 1588192363 - NICOLE CHIEKA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Gerontology Nurse Practitioner (363LG0600X) |
United | 78598 | $45.73 | 1215410873 - MACY BOSSHARD | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physician Assistant (363A00000X) |
United | 78598 | $532.79 | 1447464235 - MARK LINDSTROM | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 78598 | $463.79 | 1760992390 - YOONHA KIM | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Physician Assistant (363A00000X) |
United | 78598 | $679.69 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 78598 | $69.01 | 1114160363 - SANDRA GLICK-RIDLEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 78598 | $106.47 | 1164849154 - MOHAMMAD TOLIYAT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 78598 | $463.79 | 1790836252 - RANGADHAM NAGARAKANTI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | KY | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
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 |
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CPT 78598 vs. Other Nuclear Medicine Procedures Codes
The CPT 78598 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 78598 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) |
| 78598-CPT | Moderate | Quantitative Differential Pulmonary Perfusion, And Ventilation (Eg, Aerolsol Or Gas), 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 78598. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78598 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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