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See a sample rate comparisonCPT 78813 Fee Schedule
CPT 78813 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Tumor Imaging, Positron Emission Tomography (Pet); Whole Body
| 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 PS - PET tumor subsequent treatment strategy |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78813 |
| Medicaid Fee Schedule | $1,222.78 median of the 7 states in the free preview · View Medicaid rates for 78813 |
National average reimbursement for CPT 78813 by major payers:
$1,025.84
BCBS / Anthem
$1,776.43
UnitedHealthcare
$1,463.16
Aetna
$1,685.31
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 78813.
CPT 78813
5 of 25 sample ratesHigher to lower in this preview
Robert Reuter
Radiology Associates Of North Texas, PA
$3,480.94Published rateJoseph Schultz
Radiology Associates Of North Texas, PA
$3,229.22Published rateChristine Kneisel
Northern Arizona Healthcare Corporation
$3,183.90Published rateNauman Farooq
Northern Arizona Healthcare Corporation
$1,307.42Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$119.11Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78813 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78813. 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 |
| 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 78813. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78813 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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