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See a sample rate comparisonCPT 78999 Fee Schedule
CPT 78999 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Scan To Aid Diagnosis, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights One Or More Areas Of The Body On A Scan So That They May Be Viewed More Easily.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 78999 |
| Medicaid Fee Schedule | View Medicaid rates for 78999 |
National average reimbursement for CPT 78999 by major payers:
$1,357.72
BCBS / Anthem
$395.80
UnitedHealthcare
$1,338.66
Aetna
$648.50
Cigna
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CPT 78999
5 of 25 sample ratesHigher to lower in this preview
Peacehealth, St. John Medical Center
$2,765.53Published rateJackson Hma LLC, Merit Health Central
$736.26Published rateArizona Spine And Joint Hospital LLC
$377.11Published rateInspira Medical Centers, Inc., Inspira Medical Center Vineland
Inspira Medical Centers Inc
$361.22Published rateLarkin Community Hospital Inc
Larkin Community Hospital, Inc.
$112.30Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 78999 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78999. 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) |
| 78999-CPT | High | Scan To Aid Diagnosis, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights One Or More Areas Of The Body On A Scan So That They May Be Viewed More Easily. |
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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