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See a sample rate comparisonCPT 78804 Fee Schedule
Medicare rates as of October 2026
CPT 78804 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Rp Loclzj Tum Whbdy 2 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 Requiring 2 Or More Days Imaging
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $561.14 national non-facility rate (2026) · View Medicare rates for 78804 |
| Medicaid Fee Schedule | $464.695 median of the 8 states in the free preview · View Medicaid rates for 78804 |
National average reimbursement for CPT 78804 by major payers:
$664.16
BCBS / Anthem
$698.10
UnitedHealthcare
$706.28
Aetna
$846.17
Cigna
Compare published rates across providers.
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CPT 78804
5 of 25 sample ratesHigher to lower in this preview
Marc Liebeskind
Radiology Associates Of North Texas, PA
$1,491.45Published rateApril Schleier
Northern Arizona Healthcare Corporation
$922.78Published rateBenjamin Wilson
Radiology Associates Of North Texas, PA
$133.52Published rateKhawaja Rahman
Northern Arizona Healthcare Corporation
$91.19Published rateJohn Mougin
Northern Arizona Healthcare Corporation
$42.95Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78804 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78804. 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 |
| 78804-CPT | Moderate | Rp Loclzj Tum Whbdy 2 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 Requiring 2 Or More Days Imaging |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78804. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78804 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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