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    v1.0.30
    OpenPayerBilling CodesOther Diagnostic Nuclear Medicine ProceduresCPT cpt-78812-fdg-pet-body-imaging-for-oncologic-evaluation
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    CPT 78812: FDG PET Imaging for Detection of Malignant Tumors

    Medicare pays $89 on average nationally for this procedure.

    CPT code 78812 describes a positron emission tomography (PET) study using the radiotracer FDG to produce three-dimensional images for detecting metabolically active malignant tumors; the service is a diagnostic nuclear medicine imaging procedure typically performed in an outpatient imaging center, hospital imaging department, or cancer center and involves IV injection of FDG followed by PET acquisition to evaluate for increased radiotracer uptake consistent with malignancy.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with a history of non-small cell lung cancer presents for surveillance imaging after systemic therapy to assess for residual or recurrent disease and to stage suspected metastatic spread. The patient arrives at the nuclear medicine department after fasting for at least 4–6 hours and having a blood glucose check; an intravenous line is placed. The patient is injected with FDG (fluoro-deoxyglucose) approximately one hour prior to imaging to allow systemic distribution and uptake by metabolically active tissues. The PET/CT scanner acquires three-dimensional images capturing photon emissions from FDG uptake; images are reconstructed and reviewed by a nuclear medicine physician or radiologist for focal areas of increased uptake consistent with malignancy. The imaging encounter includes radiopharmaceutical preparation and administration, patient monitoring during uptake, image acquisition, image reconstruction, and interpretation with a written report provided to the referring oncologist.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78815Positron emission tomography (PET) imaging for tumor detection, single area, with concurrent non-contrast CT for attenuation correction and anatomic localizationPerformed when CT localization is acquired with PET; commonly billed together as PET/CT rather than PET alone
    78816Positron emission tomography (PET) imaging for tumor detection, whole body, with concurrent non-contrast CT for attenuation correction and anatomic localizationUsed when whole-body PET/CT is indicated for staging or surveillance and may accompany or replace 78812 depending on extent
    78811Positron emission tomography (PET) imaging for tumor detection, single area, without concurrent CTAlternative when CT is not acquired; relates as a component or alternative technique
    78813Positron emission tomography (PET) imaging for tumor detection, limited area, with concurrent CT for attenuation correction and anatomic localizationUsed for more focal imaging protocols when limited field-of-view with CT localization is required

    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…
    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…
    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…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    156FC0800X
    2084P2900X
    331L00000X
    363LP0200X
    251G00000X
    364SF0001X
    213EP0504X

    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-78811-TARGETED-PET-LOCALIZED-BODY-REGION

    CPT 78811: PET, limited area imaging

    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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