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See a sample rate comparisonCPT 78635 Fee Schedule
Last Verified: September 2026
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.
Cerebrospinal Fluid Scan, A Scan Of The Cerebrospinal Fluid Uses A Radioactive Substance To Produce Images Of The Fluid Flow Around And Within The Brain And Spinal Cord.
| 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 QW - CLIA Waived Tests |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78635 |
| Medicaid Fee Schedule | View Medicaid rates for 78635 |
National average reimbursement for CPT 78635 by major payers:
$369.00
$359.74
$356.33
$443.31
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CPT 78635
5 of 25 sample ratesHigher to lower in this preview
Health Imaging Partners, LLC
$950.09Published rateAlexander Kelley
Radiology Associates Of North Texas, PA
$812.95Published rateKelly Kaufman
Northern Arizona Healthcare Corporation
$296.33Published rateJonathan Dickson
Radiology Associates Of North Texas, PA
$78.50Published rateJessica Courtney
Northern Arizona Healthcare Corporation
$26.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78635 vs. Other Nuclear Medicine Procedures Codes
The CPT 78635 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 78635 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 |
|---|---|---|
| 78630-CPT | Moderate | Cerebrospinal Fluid Scan, A Scan Of The Cerebrospinal Fluid Uses A Radioactive Substance To Produce Images Of The Fluid Flow Around And Within The Brain And Spinal Cord. |
| 78635-CPT | Moderate | Cerebrospinal Fluid Scan, A Scan Of The Cerebrospinal Fluid Uses A Radioactive Substance To Produce Images Of The Fluid Flow Around And Within The Brain And Spinal Cord. |
| 78645-CPT | Moderate | Cerebrospinal Fluid Scan, A Scan Of The Cerebrospinal Fluid Uses A Radioactive Substance To Produce Images Of The Fluid Flow Around And Within The Brain And Spinal Cord. |
| 78650-CPT | Moderate | Scan Of Brain For Fluid Leak, A Radioactive Substance Is Given By Mouth Or Iv To Highlight Cerebrospinal Fluid On A Scan. Images Of The Brain And Spinal Cord Are Viewed To Learn If There Is A Leak And If So Its Location. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78635 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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