Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Musculoskeletal SystemCPT cpt-78306-full-body-bone-scan-scintigraphy
    Ask Trek AI about this page

    CPT 78306: Full‑Body Bone Scan (Scintigraphy)

    Medicare pays $180 and commercial payers pay $438 on average nationally for this procedure.

    CPT code 78306 describes a full‑body bone scan (scintigraphy), a nuclear medicine imaging study in which a radionuclide is injected and planar or whole‑body images are acquired to evaluate the skeleton for metabolic activity, fractures, infection, or metastatic disease; service type: diagnostic nuclear medicine procedure; typical site of service: outpatient imaging center or hospital nuclear medicine department.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

    Customize your policy alerts

    Sign up for cpt 78306 policy alerts

    Get alerted when payer policies referencing 78306 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    National Reimbursement Benchmarks

    Across payers the national mean for CPT 78306 shows a clear separation: Medicare’s mean of $180.50 sits well below BUCA’s average commercial mean of $438.20, indicating that commercial networks on average reimburse substantially more than Medicare for this code. Blue Cross Blue Shield and UnitedHealth Group have notably higher mean levels ($592.40 and $275.10 respectively), while Aetna and Cigna fall closer to Medicare’s mean but still above in some percentiles.

    Dispersion measured as the interquartile range (P75–P25) highlights where variability concentrates. Blue Cross Blue Shield has the widest IQR at $276.60, followed by BUCA at $269.90 and UnitedHealth Group at $270.10, indicating broad contract variability. Aetna and Cigna are tighter with IQRs of $200.40 and $305.60 respectively — Cigna’s IQR is larger than Aetna’s despite lower overall means — and Medicare’s IQR is $218.50, placing it in the mid-range of dispersion.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools
    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old female with progressive atraumatic hip and widespread musculoskeletal pain is referred from primary care to nuclear medicine for a full‑body bone scan to evaluate for occult fractures, metastatic disease, or multifocal degenerative changes. The referring diagnosis includes M81.0 (age-related osteoporosis) and M25.50 (pain in unspecified joint). The nuclear medicine department schedules the patient for injection of a technetium‑99m bone‑seeking radiopharmaceutical, with imaging performed approximately 2–4 hours post‑injection to obtain planar whole‑body anterior and posterior views. For focal concern (eg, suspected recent fracture or infection), additional spot images or SPECT may be acquired.

    The clinical workflow: referral and indication review by the ordering clinician; pre‑procedure screening for allergies and pregnancy status; intravenous radiotracer administration by a credentialed provider; uptake period in a monitored waiting area; acquisition of whole‑body planar images in the nuclear medicine imaging room; image interpretation and report generation by a radiologist or nuclear medicine physician using the appropriate provider taxonomy; communication of urgent findings to the referring clinician. Typical documentation includes indication, radionuclide and dose, imaging time relative to injection, views obtained, findings, and interpretation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2085R0202X
    2085N0700X
    2085B0100X
    363LS0200X
    124Q00000X
    246Q00000X
    225XF0002X
    261QA3000X

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-78300-BONE-SCAN-LIMITED-AREA-SCINTIGRAPHY

    CPT 78300: Bone Scan (Limited Area Scintigraphy)

    CPT-78305-BONE-SCAN-SCINTIGRAPHY-MULTI-REGION

    CPT 78305: Bone Scan (Skeletal Scintigraphy)

    CPT-78315-THREE-PHASE-BONE-SCAN-SCINTIGRAPHY

    CPT 78315: Three-Phase Bone Scan (Scintigraphy)

    CPT-78350-BONE-MINERAL-DENSITY-SINGLE-PHOTON-ABSORPTIOMETRY

    CPT 78350: Single-Energy Photon Bone Mineral Density Measurement

    CPT-78351-BONE-MINERAL-DENSITY-DUAL-ENERGY-PHOTON-ABSORPTIOMETRY

    CPT 78351: Dual-Energy Photon Bone Mineral Density Measurement

    CPT-78399-MUSCULOSKELETAL-NUCLEAR-MEDICINE-UNLISTED-PROCEDURE

    CPT 78399: Musculoskeletal Diagnostic Nuclear Medicine Procedure (Unlisted)

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    78305
    Bone and/or joint imaging; multiple areas
    Used when imaging multiple specific anatomic regions rather than a full‑body scan; may be selected if the exam is limited to several discrete areas instead of whole‑body.
    78315Bone and/or joint imaging; three‑phase studyUsed when a three‑phase bone scan is performed (flow, blood pool, delayed) for evaluation of acute processes such as osteomyelitis or complex regional pain; more extensive than a routine whole‑body scan.