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See a sample rate comparisonCPT 78804 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.
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 | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78804 |
| Medicaid Fee Schedule | View Medicaid rates for 78804 |
National average reimbursement for CPT 78804 by major payers:
$664.16
$698.10
$706.28
$846.17
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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 CPT 78804 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 78804 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 | 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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