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See a sample rate comparisonCPT 78599 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.
Unlisted Respira Proc Diagnos Nclear Medicine, Unlisted Respiratory Procedure Diagnostic Nuclear Medicine
| 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 TC - Technical component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78599 |
National average reimbursement for CPT 78599 by major payers:
$1,527.18
$102.93
$637.98
$1,294.83
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CPT 78599
5 of 25 sample ratesHigher to lower in this preview
Hmh Hospitals Corporation, Riverview Medical Center
Hackensack Meridian Health Inc
$942.79Published rateStevens County Hospital
$785.94Published rateHospital Service District No. 1 Of The Parish Of St. Mary, Bayou Bend Health System
Hospital Service District No 1 Of The Parish Of St Mary
$589.01Published rateChattanooga Hamilton County Hospital Authority, Erlanger Bledsoe
Erlanger Medical Center
$441.76Published rateSt Helena Parish Hospital, St Helena Parish Hospital
St Helena Parish Hospital
$206.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78599 vs. Other Nuclear Medicine Procedures Codes
The CPT 78599 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 78599 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 | Lung Scan For Air Flow, A Lung Perfusion Scan Uses An Inhaled Radioactive Substance To View How Air Is Distributed In The Lungs. |
| 78580-CPT | Moderate | Lung Scan For Blood Air Flow, A Lung Perfusion Scan Uses A Radioactive Substance To Highlight Blood Flow On Images. A Lung Ventilation Scan May Be Done In The Same Session. It Uses Contrast Material To Produce A Picture Of How Air Is Distributed 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) |
| 78599-CPT | High | Unlisted Respira Proc Diagnos Nclear Medicine, Unlisted Respiratory 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 78599. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78599 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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