CPT 78999 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 • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | High |
National average reimbursement for CPT 78999 by major payers:
$1,357.72
$395.80
$1,338.66
$655.61
| 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 78999 | ||||||
United | 78999 | $848.52 | 1932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA | 270059959 - (LA) NMC OPERATING COMPANY LLC | LA | General Acute Care Hospital (282N00000X) |
United | 78999 | $942.79 | 1831197508 - MERIDIAN HOSPITALS CORPORATION, BAYSHORE COMMUNITY HOSPITAL | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 78999 | $1154.96 | 1437175734 - VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY, VCU MEDICAL CENTER | 541848065 | VA | General Acute Care Hospital (282N00000X) |
United | 78999 | $848.52 | 1720038946 - HCA HEALTHONE LLC, PRESBYTERIAN/ST. LUKE'S MEDICAL CENTER | 841321373 | CO | General Acute Care Hospital (282N00000X) |
United | 78999 | $321.82 | 1710075361 - GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT | 430975390 - GOLDEN VALLEY MEMORIAL HOSPITAL DISTRICT | MO | General Acute Care Hospital (282N00000X) |
United | 78999 | $828.28 | 1265486278 - EAST GEORGIA REGIONAL MEDICAL CENTER, LLC, EAST GEORGIA REGIONAL MEDICAL CENTER LLC | 582190713 - (GA) EAST GEORGIA REGIONAL MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 78999 | $866.22 | 1427048453 - MEDINA COUNTY HOSPITAL DISTRICT, MEDINA REGIONAL HOSPITAL | 270492434 | TX | Critical Access Hospital (282NC0060X) |
United | 78999 | $628.75 | 1124052162 - CITIZENS MEDICAL CENTER COUNTY OF VICTORIA, COUNTY OF VICTORIA CITIZENS MEDICAL CENTER | 741698143 | TX | General Acute Care Hospital (282N00000X) |
United | 78999 | $625.82 | 1609345685 - MOUNTAIN VISTA MEDICAL CENTER, LP, FLORENCE HOSPITAL, A CAMPUS OF MOUNTAIN VISTA MEDICAL CENTER | 202066363 - (AZ) MOUNTAIN VISTA MEDICAL CENTER LP | AZ | General Acute Care Hospital (282N00000X) |
United | 78999 | $603.39 | 1003898313 - MOREHOUSE GENERAL HOSPITAL | 726011528 - (LA) MOREHOUSE GENERAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 78999 | $416.35 | 1760567085 - STARR COUNTY HOSPITAL DISTRICT, STARR COUNTY MEMORIAL HOSPITAL | 741794256 | TX | Rural Acute Care Hospital (282NR1301X) |
United | 78999 | $594.04 | 1821019571 - FLORIDA HOSPITAL WATERMAN INC, ADVENTHEALTH WATERMAN | 593140669 - (FL) FLORIDA HOSPITAL WATERMAN INC | FL | General Acute Care Hospital (282N00000X) |
United | 78999 | $1058.71 | 1922139120 - INOVA HEALTH CARE SERVICES, INOVA MOUNT VERNON HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 78999 | $594.04 | 1427068345 - UNIVERSITY COMMUNITY HOSPITAL, INC, FLORIDA HOSPITAL CARROLLWOOD | 591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 78999 | $716.53 | 1962455816 - CHCA CONROE LP, CONROE REGIONAL MEDICAL CENTER | 621801361 - (TX) CHCA CONROE LP | TX | 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 78999 vs. Other Nuclear Medicine Procedures Codes
The CPT 78999 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 78999 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) |
| 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) |
| 78999-CPT | High | Unlisted Miscellaneous Procedure, Diagnostic Nuclear Medicine |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78999 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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