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See a sample rate comparisonCPT 78811 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.
Positron Emission Tomogra (Pet) Imag; Lmtd Area (Eg Chst H, Positron Emission Tomography (Pet) Imaging; Limited Area (Eg Chest H
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 26 - Professional component PI - PET tumor initial treatment strategy |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78811 |
| Medicaid Fee Schedule | View Medicaid rates for 78811 |
National average reimbursement for CPT 78811 by major payers:
$875.76
$1,558.23
$1,406.40
$1,437.07
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CPT 78811
5 of 25 sample ratesHigher to lower in this preview
Health Imaging Partners LLC
$5,728.68Published rateDavid Dinan
Radiology Associates Of North Texas, PA
$3,229.22Published rateLeanne Mcnabney
Town Center Orthopaedic Associates, P.C.
$1,614.69Published rateRebeca Stanley
Radiology Associates Of North Texas, PA
$198.50Published rateNorthern Arizona Healthcare Corporation
$65.65Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78811 vs. Other Nuclear Medicine Procedures Codes
The CPT 78811 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 78811 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 |
| 78811-CPT | Moderate | Positron Emission Tomogra (Pet) Imag; Lmtd Area (Eg Chst H, Positron Emission Tomography (Pet) Imaging; Limited Area (Eg Chest H |
| 78812-CPT | High | Positron Emission Tomogra (Pet) Imag; Skull Base To Mid-Thigh, Positron Emission Tomography (Pet) Imaging; Skull Base To Mid-Thigh |
| 78813-CPT | High | Tumor Imaging, Positron Emission Tomography (Pet); Whole Body |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78811 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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