CPT 78814 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Nuclear Medicine Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • PI - PET tumor initial treatment strategy • 26 - Professional component |
| Complexity Level | High |
National average reimbursement for CPT 78814 by major payers:
$1,119.37
$1,834.67
$1,558.20
$1,812.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 78814 | ||||||
United | 78814 | $3700.85 | 1356828172 - HMH HOSPITALS CORPORATION, RARITAN BAY MEDICAL CENTER-OLD BRIDGE | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78814 | $3401.01 | 1235134024 - VIRTUA OUR LADY OF LOURDES HOSPITAL INC, VIRTUA OUR LADY OF LOURDES HOSPITAL | 210635001 - (NJ) VIRTUA OUR LADY OF LOURDES HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78814 | $3443.05 | 1861102345 - ADVENTHEALTH PALM COAST PARKWAY INC, ADVENTHEALTH PALM COAST PARKWAY | 882288563 - (FL) ADVENTHEALTH PALM COAST PARKWAY INC | FL | General Acute Care Hospital (282N00000X) |
United | 78814 | $2341.27 | 1275511651 - ADVENTIST HEALTH SYSTEM-SUNBELT INC, ADVENTHEALTH LAB | 590725553 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | Critical Access Hospital (282NC0060X) |
United | 78814 | $450.00 | 1952347049 - MIDWEST MEDICAL ASSOCIATES INC., SOUTHWEST MEDICAL CENTER - RADIOLOGY | 431907608 - (MO) MIDWEST MEDICAL ASSOCIATES INC | MO | Radiology Clinic/Center (261QR0200X) |
United | 78814 | $771.41 | 1124111414 - QMG LLC DBA INSITE RADIOLOGY | 650730095 - (FL) QUALCARE MEDICAL GROUP, LLC | FL | Radiology Clinic/Center (261QR0200X) |
United | 78814 | $1800.00 | 1003318049 - TRI COUNTY PET LLC, PET IMAGING INSTITUTE OF SOUTH FL. | 522201971 - (FL) TRI COUNTY PET LLC | FL | Radiology Clinic/Center (261QR0200X) |
United | 78814 | $1818.80 | 1396837951 - CENTRAL IOWA HOSPITAL CORPORATION, IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 78814 | $1480.33 | 1427360700 - VHS HARPER-HUTZEL HOSPITAL INC, HARPER UNIVERSITY HOSPITAL | 272844767 | MI | General Acute Care Hospital (282N00000X) |
United | 78814 | $11509.20 | 1073510277 - PEACEHEALTH, ST. JOHN MEDICAL CENTER | 910564987 | WA | General Acute Care Hospital (282N00000X) |
United | 78814 | $2132.09 | 1508842964 - ANIMAS SURGICAL HOSPITAL, LLC, ANIMAS SURGICAL HOSPITAL | 161632441 - (CO) ANIMAS SURGICAL HOSPITAL LLC | CO | General Acute Care Hospital (282N00000X) |
United | 78814 | $4534.68 | 1760488266 - ST. LUKE'S WARREN HOSPITAL, INC. | 221494454 - (NJ) ST LUKES WARREN HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78814 | $2453.25 | 1225086028 - ST LUKES MEDICAL CENTER LP | 621795587 | AZ | General Acute Care Hospital (282N00000X) |
United | 78814 | $108.90 | 1861918815 - PROFESSIONAL RADIOLOGY PLLC | 472177210 - (TX) PROFESSIONAL RADIOLOGY PLLC | TX | Radiology Clinic/Center (261QR0200X) |
United | 78814 | $1171.28 | 1548284177 - WESTCHESTER GENERAL HOSPITAL, INC., KERALTY HOSPITAL | 591201323 - (FL) WESTCHESTER GENERAL HOSPITAL, INC. | FL | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 78814 vs. Other Nuclear Medicine Procedures Codes
The CPT 78814 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 78814 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 |
|---|---|---|
| 78814-CPT | High | Position Emission Tomography (Pet) With Concurrently Acquired Computed Tomography (Ct) For Attenuation Correction And Anatomical Localization Imaging; Limited Area (Eg Check Head/Neck) |
| 78815-CPT | High | Position Emission Tomography (Pet) With Concurrently Acquired Computed Tomography (Ct) For Attenuation Correction And Anatomical Localization Imaging; Skull Base To Mid-Thigh |
| 78816-CPT | High | Position Emission Tomography (Pet) With Concurrently Acquired Computed Tomography (Ct) For Attenuation Correction And Anatomical Localization Imaging; Whole Body |
| 78831-CPT | Moderate | Radiopharmaceutical Localization Of Tumor Inflammatory Process Or Distribution Of Radiopharmaceutical Agent(S) (Includes Vascular Flow And Blood Pool Imaging When Performed); Tomographic (Spect) Minimum 2 Areas (Eg Pelvis And Knees Chest And Abdomen) Or Separate Acquisitions (Eg Lung Ventilation And Perfusion) Single Day Imaging Or Single Area Or Acquisition Over 2 Or More Day(Desc Rvsd 1/1/23) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78814 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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