CPT 78803 Fee Schedule

Medicare rates as of October 2026

CPT 78803 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.

Rp Loclzj Tum Spect 1 Area, Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical 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

Key Fact	Detail
Service Type	Radiology Procedures Nuclear Medicine Procedures
Common Place of Service	22 - On Campus Outpatient Hospital 11 - Office
Common Modifiers	26 - Professional component TC - Technical component
Complexity Level	Moderate
Medicare Fee Schedule	$335.68 national non-facility rate (2026) · View Medicare rates for 78803
Medicaid Fee Schedule	$276.435 median of the 8 states in the free preview · View Medicaid rates for 78803

National average reimbursement for CPT 78803 by major payers:

$403.46

BCBS / Anthem

$424.41

UnitedHealthcare

$468.25

Aetna

$510.19

Cigna

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CPT 78803

5 of 25 sample ratesHigher to lower in this preview

St Francis Medical Center, Inc
St Francis Medical Center Inc
LAGeneral Acute Care HospitalNPI 1295723229Tax ID 72-0408970
$2,938.37Published rate
Emerus Bhs Sa Thousand Oaks, LLC, Baptist Neighborhood Hospital Schertz
Emerus Bhs Sa Thousand Oaks LLC
TXGeneral Acute Care HospitalNPI 1639422504Tax ID 45-2497248
$1,305.93Published rate
Columbia Plaza Medical Center Of Fort Worth Subsidiary Lp, Medical City Fort Worth
Columbia Plaza Medical Center Of Fort Worth Subsidiary Lp
TXGeneral Acute Care HospitalNPI 1659323772Tax ID 62-1682202
$611.65Published rate
Brittany Ptachick
Hroa 401k Plan
VAFamily Nurse PractitionerNPI 1053866707Tax ID 54-1958039
$275.89Published rate
El Campo Memorial Hospital
TXGeneral Acute Care HospitalNPI 1003192311Tax ID 45-2750258
$53.77Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 78803 vs. Other Nuclear Medicine Procedures Codes

The table lists codes related to 78803. Select one to see its fee schedule.

Code	Complexity	Description
78800-CPT	Moderate	Rp Loclzj Tum 1 Area 1 D Img, 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
78801-CPT	Moderate	Rp Loclzj Tum 2 Area 1 D Img, Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical 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
78802-CPT	Moderate	Rp Loclzj Tum Whbdy 1 D Img, Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical Agent S Includes Vascular Flow And Blood Pool Imaging When Performed Planar Whole Body Single Day Imaging
78803-CPT	Moderate	Rp Loclzj Tum Spect 1 Area, Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical 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

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78803. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 78803 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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