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See a sample rate comparisonCPT 78830 Fee Schedule
Medicare rates as of October 2026
CPT 78830 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
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)
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $420.85 national non-facility rate (2026) · View Medicare rates for 78830 |
| Medicaid Fee Schedule | $347.41 median of the 8 states in the free preview · View Medicaid rates for 78830 |
National average reimbursement for CPT 78830 by major payers:
$518.79
BCBS / Anthem
$577.25
UnitedHealthcare
$578.58
Aetna
$691.74
Cigna
Compare published rates across providers.
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CPT 78830
5 of 25 sample ratesHigher to lower in this preview
Margarita Bobonis Babilonia
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$685.70Published rateJon Boettger
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$556.59Published rateSheethal Cyriac
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$472.22Published rateJena Schmitz
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$472.20Published rateAlexa Merchant
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$84.37Published rate
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See a sample payer proposalCPT 78830 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78830. Select one to see its fee schedule.
| 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. |
| 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) |
| 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) |
| 78832-CPT | High | Rp Loclzj Tum Spect W Ct 2, 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 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 Days |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78830 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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Frequently Asked Questions
To find out the cost of a specific medical procedure, you generally need to know the CPT (Current Procedural Terminology) code for that service and your specific location. Your insurance company can also provide an estimate of your out-of-pocket costs based on your plan's benefits. For a direct search of procedure costs using a CPT code and location, you can use tools like Payerprice, which offers a fee schedule lookup tool.
A CPT (Current Procedural Terminology) code is a standardized five-digit code used by medical professionals to report medical, surgical, and diagnostic services to entities like insurers and government agencies. It's crucial for pricing because it precisely identifies the specific service performed, allowing for accurate billing and price comparison. When looking up prices for a procedure, knowing its CPT code will give you the most accurate and comparable cost information.
Healthcare prices can vary significantly due to a multitude of factors. These include differences in negotiated rates between healthcare providers and insurance companies, the type of facility (e.g., hospital vs. outpatient clinic), geographical location, the complexity of the patient's case, and whether the provider is in-network or out-of-network. Hospital systems often have different "chargemaster" prices, and insurance plans negotiate discounts off these listed prices, leading to a wide range of actual costs for patients.
While government initiatives like the Hospital Price Transparency Rule require hospitals to publish their standard charges, finding a single, comprehensive government website for all medical costs across all providers can be challenging. These published charges are often the "list prices" (chargemaster prices) and not necessarily what an insured patient or even the insurance company actually pays. For specific, actionable pricing information based on CPT codes and location, especially when considering what insurers and patients actually pay, tools like Payerprice are more effective than relying solely on government data.
Payerprice is a service that provides a fee schedule lookup tool, allowing users to search for healthcare procedure costs using CPT codes and specific locations. It helps consumers and healthcare professionals understand the estimated costs of medical services, making healthcare pricing more transparent and accessible. It can be a valuable resource for comparing prices before a procedure.