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    v1.0.30
    OpenPayerBilling CodesOther Diagnostic Nuclear Medicine ProceduresCPT cpt-78811-targeted-pet-localized-body-region
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    CPT 78811: PET, limited area imaging

    Medicare pays $70 on average nationally for this procedure.

    CPT code 78811 describes a diagnostic positron emission tomography (PET) procedure focused on a small, defined anatomic area to produce three-dimensional images of functional processes for detection and evaluation of tumor cells; the service is a targeted PET imaging study (diagnostic nuclear medicine) typically performed in an outpatient imaging center, hospital radiology/nuclear medicine department, or ambulatory surgical center.

    For related coverage guidance, see recent payer policy updates: Vafseo (vadadustat) for anemia in CKD on dialysis, Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family Plans, Kerendia (finerenone) — Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with a history of non-small cell lung cancer and new focal pulmonary uptake on surveillance imaging is referred for a targeted PET scan of the chest. The nuclear medicine team schedules a positron emission tomography focused on a small, defined area to assess metabolic activity within a pulmonary nodule and evaluate for local recurrence or metastatic disease. Prior to the study, the patient receives radiotracer injection, has a period of uptake time, and then is positioned for imaging of the chest region only. The procedure is typically ordered by an oncology or thoracic surgery provider, performed in an outpatient imaging center or hospital nuclear medicine department, and includes image acquisition, processing, and interpretation by a radiologist or nuclear medicine physician. Results are reported to the referring clinician to guide staging, biopsy planning, or treatment decisions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78811PET, single area, limited study (small, defined area)Primary procedure code describing focused PET imaging for a small anatomic region
    78812PET, single area, limited study with qualificationOften used for single-area PET with different protocol or equipment (site-specific use)
    78814PET, whole body, with attenuation correctionPerformed when a whole-body survey is required after a limited PET to assess for additional lesions
    78815PET with concurrent CT for attenuation correction and localizationPerformed alongside PET to provide anatomic localization and improve diagnostic accuracy
    78816PET CPT add-on for diagnostic CT interpretationWhen low-dose or diagnostic CT is performed and separately reported with PET study

    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…
    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…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    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
    207RH0000X
    363L00000X
    2084P0800X
    261QM0850X
    364SN0800X
    2471S1302X
    286500000X
    2081N0008X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 3

    10 rows

    PolicyPayerEffective Date
    Vafseo (vadadustat) for anemia in CKD on dialysisCigna2026-08-15
    Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family PlansCigna2026-08-15
    Kerendia (finerenone) — Coverage CriteriaBlue Cross Blue Shield - Iowa2026-08-05
    Voyxact (sibeprenlimab-szsl) — Prior authorization / medical necessity for primary IgA nephropathyColorado Rocky Mountain Health Plans2026-08-01
    Oxlumo (lumasiran) and Rivfloza (nedosiran) — Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Korsuva (difelikefalin) — Medical Benefit Drug Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Complement Inhibitors - EmpaveliCigna2026-08-01
    Tolvaptan (Jynarque)Cigna2026-08-01
    Nephrology - Filspari (sparsentan) coverageCigna2026-08-01
    Rivfloza (nedosiran) prior authorization for PH1UnitedHealthcare2026-08-01

    Related Codes

    CPT-78800-PLANAR-NUCLEAR-MEDICINE-SINGLE-AREA-TUMOR-LOCALIZATION

    CPT 78800: Planar Nuclear Medicine Imaging, Single Area

    CPT-78801-MULTI-DAY-MULTI-AREA-NUCLEAR-MEDICINE-IMAGING

    CPT 78801: Multi-Day/Multi-Area Nuclear Medicine Tumor Localization

    CPT-78802-WHOLE-BODY-NUCLEAR-MEDICINE-IMAGING

    CPT 78802: Whole-Body Nuclear Medicine Imaging for Tumor/Inflammation Localization

    CPT-78803-SPECT-SINGLE-AREA-LOCALIZATION

    CPT 78803: Single-Day SPECT Tumor/Tracer Localization

    CPT-78804-MULTIDAY-WHOLE-BODY-NUCLEAR-IMAGING-GAMMA-TRACER

    CPT 78804: Whole-Body Nuclear Medicine Imaging, Multi-Day

    CPT-78808-RADIOTRACER-INJECTION-GAMMA-PROBE-LOCALIZATION

    CPT 78808: Radioguided Localization with Intravenous Radiotracer

    CPT-78812-FDG-PET-BODY-IMAGING-FOR-ONCOLOGIC-EVALUATION

    CPT 78812: FDG PET Imaging for Detection of Malignant Tumors

    CPT-78813-WHOLE-BODY-PET

    CPT 78813: PET Whole Body Scan

    CPT-78814-PET-CT-TUMOR-LOCALIZATION-METABOLIC-EVALUATION

    CPT 78814: PET/CT Tumor Localization and Metabolic Imaging

    CPT-78815-PET-CT-TUMOR-IMAGING-ANATOMICAL-LOCALIZATION

    CPT 78815: PET/CT Tumor Imaging with Anatomical Localization

    Showing 1–10 of 16

    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.
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