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 |
| Medicare Fee Schedule | View Medicare rates for 78999 |
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 | $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 | $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 | $112.30 | 1952311243 - LARKIN COMMUNITY HOSPITAL INC | 650729921 - (FL) LARKIN COMMUNITY HOSPITAL, INC. | FL | General Acute Care Hospital (282N00000X) |
United | 78999 | $603.39 | 1184993727 - RUSH HOSPITAL/BUTLER, INC, OCHSNER CHOCTAW GENERAL | 640655993 - RUSH HOSPITAL-BUTLER INC | AL | Critical Access Hospital (282NC0060X) |
United | 78999 | $377.11 | 1255640819 - VHS OF ARROWHEAD, INC., ABRAZO ARIZONA HEART HOSPITAL | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 78999 | $881.52 | 1225777808 - TOTOWA CANCER CENTER | 880721476 - (NJ) TOTOWA CANCER CENTER | NJ | Radiation Oncology Clinic/Center (261QX0203X) |
United | 78999 | $377.11 | 1396745832 - ARIZONA SPINE AND JOINT HOSPITAL LLC | 364399746 - (AZ) ARIZONA SPINE AND JOINT HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 78999 | $377.11 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 78999 | $377.11 | 1912937624 - HILTON HEAD HEALTH SYSTEM, L.P., HILTON HEAD HOSPITAL | 934604680 | SC | General Acute Care Hospital (282N00000X) |
United | 78999 | $345.58 | 1528387842 - DESOTO COUNTY HOSPITAL DISTRICT, DESOTO MEMORIAL HOSPITAL | 591205441 - (FL) DESOTO MEMORIAL HOSPITAL | FL | Rural Acute Care Hospital (282NR1301X) |
United | 78999 | $520.83 | 1396857488 - COOPERMAN BARNABAS MEDICAL CENTER INC | 221494440 - (NJ) SAINT BARNABAS MEDICAL CENTER | NJ | 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 | $377.11 | 1821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER | 934555562 | SC | General Acute Care Hospital (282N00000X) |
United | 78999 | $309.16 | 1023338142 - METDALSPI, LLC, METHODIST HOSPITAL FOR SURGERY | 263195791 | TX | General Acute Care Hospital (282N00000X) |
United | 78999 | $377.11 | 1700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 78999) and we'll show you how you compare in 15 minutes or less.