CPT 78801 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 • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78801 |
National average reimbursement for CPT 78801 by major payers:
$302.41
$305.81
$308.06
$373.90
| 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 78801 | ||||||
United | 78801 | $402.01 | 1922413285 - STEVEN NUANES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Internal Medicine Physician (207R00000X) |
United | 78801 | $67.80 | 1609950500 - MICHAEL REIDY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Pulmonary Disease Physician (207RP1001X) |
United | 78801 | $31.60 | 1386872166 - NIKI POPP | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Anesthesiology Physician (207L00000X) |
United | 78801 | $334.20 | 1205822665 - DANIEL BLAKE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NV | Anesthesiology Physician (207L00000X) |
United | 78801 | $67.80 | 1356671044 - HOLLY BOWYER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Acute Care Nurse Practitioner (363LA2100X) |
United | 78801 | $307.48 | 1396010856 - BERTRAND LIANG | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Neurology Physician (2084N0400X) |
United | 78801 | $67.80 | 1588744270 - MICHAEL MACDONALD | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Urology Physician (208800000X) |
United | 78801 | $402.01 | 1306040258 - DEREK FEUQUAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 78801 | $582.84 | 1558576348 - ROBERT WEISSMANN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 78801 | $402.01 | 1669733580 - EDWARD JACKMAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MA | Family Medicine Physician (207Q00000X) |
United | 78801 | $168.52 | 1598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO | 832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC | FL | Home Health Agency (251E00000X) |
United | 78801 | $685.71 | 1912394495 - ENIOLA FAGBONGBE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 78801 | $217.80 | 1790002350 - KRISTOPHER DAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IA | Surgery Physician (208600000X) |
United | 78801 | $67.80 | 1629270731 - DIPAK JANA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Cardiovascular Disease Physician (207RC0000X) |
United | 78801 | $217.80 | 1790002350 - KRISTOPHER DAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | RI | Surgery Physician (208600000X) |
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 78801 vs. Other Nuclear Medicine Procedures Codes
The CPT 78801 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 78801 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 |
|---|---|---|
| 78800-CPT | Moderate | Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging When Performed); Planar Single Area (Eg Head Neck Chest Pelvis) Single Day Imaging (Desc Rvsd 1/1/20) |
| 78801-CPT | Moderate | Radiopharmaceutical Localization Of Tumor Inflamm-Atory Process Or Distribution Of Radiopharmaceuti-Cal Agent(S) (Includes Vascular Flow And Blood Pool Imaging When Performed); Planar 2 Or More Areas (Eg Abdomen And Pelvis Head And Chest) 1 Or More Days Imaging Or Single Area Imaging Over 2 Or More Days (Desc Rvsd 1/1/20) |
| 78802-CPT | Moderate | Radiopharmaceutical Localization Of Tumor Inflamm-Atory Process Or Distribution Of Radiopharmaceuti-Cal Agent(S) (Includes Vascular Flow And Blood Pool Imaging When Performed); Planar Whole Body Single Day Imaging (Desc Rvsd 1/1/20) |
| 78803-CPT | Moderate | Radiopharmaceutical Localization Of Tumor Inflamm-Atory Process Or Distribution Of Radiopharmaceuti-Cal Agent(S) (Includes Vascular Flow And Blood Pool Imaging When Performed); Tomographic (Spect) Single Area (Eg Head Neck Chest Pelvis) Or Acquisition Single Day Imaging (Desc Rvsd 1/1/23) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78801 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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