CPT 78699 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Nuclear Medicine Procedures |
| Complexity Level | High |
National average reimbursement for CPT 78699 by major payers:

$1,946.24

$123.79

$1,696.66

$797.97
| 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 78699 | ||||||
United | 78699 | $309.16 | 1144274226 - NAVARRO HOSPITAL LP, NAVARRO REGIONAL HOSPITAL | 621762428 | TX | General Acute Care Hospital (282N00000X) |
United | 78699 | $377.11 | 1639422504 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL SCHERTZ | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 78699 | $386.54 | 1427098169 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL ST LOUIS | 430653493 - MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 78699 | $920.33 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 78699 | $866.22 | 1174522494 - CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO 1, OMNIPOINT HEALTH HOSPITAL | 760153629 | TX | Critical Access Hospital (282NC0060X) |
United | 78699 | $500.20 | 1356345318 - NEBRASKA ORTHOPAEDIC HOSPITAL LLC | 470845237 - (NE) NEBRASKA ORTHOPAEDIC HOSPITAL LLC | NE | General Acute Care Hospital (282N00000X) |
United | 78699 | $918.48 | 1770671182 - NEWARK WAYNE COMMUNITY HOSPITAL | 150584188 - NEWARK WAYNE COMMUNITY HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 78699 | $920.33 | 1780638833 - CARTERSVILLE MEDICAL CENTER LLC, CARTERSVILLE MEDICAL CENTER | 582433438 - (GA) CARTERSVILLE MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 78699 | $386.54 | 1285664177 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 78699 | $866.22 | 1134125016 - VIRTUA, VIRTUA MOUNT HOLLY HOSPITAL | 210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78699 | $828.28 | 1720078702 - WELLINGTON REGIONAL MEDICAL CENTER LLC, WELLINGTON REGIONAL MEDICAL CENTER | 232306491 | FL | General Acute Care Hospital (282N00000X) |
United | 78699 | $303.67 | 1063175578 - MERCY HEALTH, MERCY HEALTH - ST. ANNE HOSPITAL | 344428250 - MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC | OH | General Acute Care Hospital (282N00000X) |
United | 78699 | $377.11 | 1487218509 - SMSJ TUCSON HOLDINGS, LLC, CARONDELET MARANA HOSPITAL | 474131755 | AZ | General Acute Care Hospital (282N00000X) |
United | 78699 | $920.33 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 78699 | $625.82 | 1447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
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 78699 vs. Other Nuclear Medicine Procedures Codes
The CPT 78699 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 78699 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78699. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78699 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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