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See a sample rate comparisonCPT 78835 Fee Schedule
CPT 78835 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Radiopharmaceutical Quantifica, Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure)
| 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 PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 78835 |
| Medicaid Fee Schedule | $73.25 median of the 8 states in the free preview · View Medicaid rates for 78835 |
National average reimbursement for CPT 78835 by major payers:
$115.21
BCBS / Anthem
$120.94
UnitedHealthcare
$114.68
Aetna
$150.92
Cigna
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CPT 78835
5 of 25 sample ratesHigher to lower in this preview
Uzoma Igboagi
Radiology Associates Of North Texas, PA
$208.42Published rateBen Cranfill
Northern Arizona Healthcare Corporation
$138.61Published rateChristopher Raio
St Francis Hospital
$111.61Published rateRyan Richter
Radiology Associates Of North Texas, PA
$57.72Published rateMichael Jacobson
Hroa 401k Plan
$18.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78835 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78835. 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. |
| 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. |
| 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) |
| 78835-CPT | Low | Radiopharmaceutical Quantifica, Radiopharmaceutical Quantification Measurement(S) Single Area (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78835. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78835 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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