CPT 78815 is a medical code for Position Emission Tomography (Pet) With Concurrently Acquired Computed Tomography (Ct) For Attenuation Correction And Anatomical Localization Imaging; Skull Base To Mid-Thigh. It is used by healthcare providers to document and receive reimbursement for relevant procedures.

What factors influence the fee schedule for CPT 78815?

Factors affecting fee schedules include government-set Medicare & Medicaid rates, negotiated private insurance rates, geographic location (costs may be higher in urban areas), and provider type (hospital providers may have different rates than private practice).

How can PayerPrice help with CPT 78815 fee schedules?

PayerPrice allows users to benchmark their current rates against market averages to identify opportunities for rate optimization, prospect for new business using fee schedules, and integrate real-time payer data into their workflows via API or SQL.

Where can I find specific Medicare rates for CPT 78815?

You can view specific Medicare rates for CPT 78815 for the year 2025 on the PayerPrice website: https://payerprice.com/medicare-fee-schedule-lookup?codes=78815&year=2025,2026&medicareType=physician_ffs

How can I find out the cost of a specific medical procedure?

To determine the cost of a medical procedure, you can first ask your healthcare provider for an estimated cost. For more detailed and specific pricing information tailored to CPT codes and your location, you can utilize tools like Payerprice, which offers a comprehensive fee schedule lookup tool.

What is a CPT code and why is it important?

CPT stands for Current Procedural Terminology. CPT codes are a set of standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to insurance companies and other payers. They are crucial for accurate billing, processing claims, and understanding the specific services provided during a healthcare encounter.

Where can I look up fee schedules for medical services?

Fee schedules for medical services can vary significantly based on the payer, geographic location, and specific CPT code. For detailed and specific fee schedule information tailored to particular CPT codes and your location, Payerprice offers a specialized fee schedule lookup tool that allows users to search for this data.

Why do medical costs vary so much between different providers or locations?

Medical costs can vary significantly due to a multitude of factors, including the type of facility (e.g., hospital vs. outpatient clinic), geographic location (impacting labor and overhead costs), negotiated rates with different insurance companies, the complexity of the service, the technology used, and the provider's experience. These variations highlight the importance of researching costs.

Is there a tool available to help compare prices for medical services?

Yes, there are tools designed to help compare prices for medical services. For a granular comparison based on specific CPT codes and your location, Payerprice provides a fee schedule lookup tool that allows users to search for pricing information, assisting them in understanding and comparing potential costs.

CPT 78815 Fee Schedule

Last Verified: September 2026

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.

Pet Scan With Ct Scan, A Pet (Positron Emission Tomography) Scan Creates Images By Detecting A Radioactive Substance That Has Been Given By Mouth Or Iv. A Ct (Computed Tomography) Scan May Be Superimposed For Enhanced Views.

Key Fact	Detail
Service Type	Radiology Procedures Nuclear Medicine Procedures
Common Place of Service	22 - On Campus Outpatient Hospital 11 - Office
Common Modifiers	None PS - PET tumor subsequent treatment strategy 26 - Professional component
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 78815
Medicaid Fee Schedule	View Medicaid rates for 78815

National average reimbursement for CPT 78815 by major payers:

$1,187.32

$1,889.54

$1,687.01

$1,853.67

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CPT 78815

5 of 25 sample ratesHigher to lower in this preview

Lindsey Shea Johnstone
Vanderbilt University Medical Center
TNDiagnostic Radiology PhysicianNPI 1447630728Tax ID 35-2528741
$3,660.27Published rate
Rishu Batra
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
FLInternal Medicine PhysicianNPI 1427670900Tax ID 59-3238640
$1,842.90Published rate
Vincent Jones
White-Wilson Medical Center, PA
FLDiagnostic Radiology PhysicianNPI 1285628743Tax ID 59-3000333
$1,720.75Published rate
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572
$287.91Published rate
Nicole Schwab
Allergy & Asthma Of Dupage, S.C.
ILFamily Nurse PractitionerNPI 1164776688Tax ID 36-2925195
$112.39Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 78815 vs. Other Nuclear Medicine Procedures Codes

The CPT 78815 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 78815 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	Pet Scan With Ct Scan, A Pet (Positron Emission Tomography) Scan Creates Images By Detecting A Radioactive Substance That Has Been Given By Mouth Or Iv. A Ct (Computed Tomography) Scan May Be Superimposed For Enhanced Views.
78815-CPT	High	Pet Scan With Ct Scan, A Pet (Positron Emission Tomography) Scan Creates Images By Detecting A Radioactive Substance That Has Been Given By Mouth Or Iv. A Ct (Computed Tomography) Scan May Be Superimposed For Enhanced Views.
78816-CPT	High	Pet Scan With Ct Scan, A Pet (Positron Emission Tomography) Scan Creates Images By Detecting A Radioactive Substance That Has Been Given By Mouth Or Iv. A Ct (Computed Tomography) Scan May Be Superimposed For Enhanced Views.
78830-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) With Concurrently Acquired Computed Tomography (Ct) Transmission Scan For Anatomical Review Localization And Determination/Detection Of Pathology Single Area (Eg Head Neck Chest Pelvis Or Acquisition Singledayimaging(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 78815. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 78815 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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CPT 78815 Fee Schedule

Lindsey Shea Johnstone

Rishu Batra

Vincent Jones

Chu Chen

Nicole Schwab