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CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

CPT code 78814 represents a combined positron emission tomography and computed tomography (PET/CT) fusion scan used to localize tumors and assess their metabolic activity before starting active cancer treatment. Nationally, this code is important because PET/CT fusion influences oncology staging, treatment planning, and monitoring, and it is commonly billed in outpatient imaging settings and hospital radiology departments. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what CPT code 78814 covers clinically, where the service is typically delivered, and which carriers commonly reimburse the service. The publication summarizes typical application of PET/CT fusion in oncology, outlines common billing considerations tied to the service line, and highlights payer coverage patterns and policy language where available. Benchmarks and utilization context are provided to help billing managers and policy analysts understand national trends in the use of PET/CT fusion for tumor localization and metabolic assessment. Data not available in the input is identified explicitly.

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Billing Code Overview

CPT code 78814 describes a combined positron emission tomography and computed tomography (PET/CT) fusion diagnostic procedure used to evaluate the location and metabolic activity of tumors or cancer prior to initiating active treatment. The procedure acquires PET images that show metabolic processes and CT images that provide anatomic detail; these are fused to create a single, more informative image for staging, treatment planning, and assessment of disease extent.

Service type: Diagnostic imaging; PET/CT fusion study
Typical site of service: Hospital outpatient imaging departments, freestanding diagnostic imaging centers, and outpatient radiology suites

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CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

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Billing Code Overview

Service type: Diagnostic imaging; PET/CT fusion study
Typical site of service: Hospital outpatient imaging departments, freestanding diagnostic imaging centers, and outpatient radiology suites

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a recent biopsy-confirmed non-small cell lung carcinoma is referred for staging prior to initiation of systemic therapy. The oncology team orders a combined positron emission tomography and computed tomography study to evaluate primary tumor metabolic activity, identify regional nodal involvement, and detect distant metastatic disease. The patient presents to an outpatient imaging center where technologists screen for contraindications, obtain intravenous access for radiotracer administration, and document medications and blood glucose. After radiotracer uptake time, the nuclear medicine physician supervises imaging acquisition on a hybrid PET/CT scanner, including low-dose CT for attenuation correction and diagnostic-quality CT when indicated. Images are fused and interpreted by the nuclear medicine or radiology physician, who reports standardized uptake values, anatomic localization of hypermetabolic lesions, and compares with prior imaging. The report is routed to the referring medical oncologist and entered into the electronic medical record for treatment planning and authorization of therapies.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional Component	When billing only the physician interpretation portion of the PET/CT (technical component billed separately).
`TC`	Technical Component	When billing only the facility/technical portion (scanner, radiotracer, technologist).
`52`	Reduced Services	When the study is partially completed or limited (e.g., abbreviated protocol due to patient intolerance).
`53`	Discontinued Procedure	When the PET/CT is started but terminated due to an unforeseen complication.
`78`	Unplanned Return to OR/Productive Procedure Following Initial Service	Rare for PET/CT; used if an unexpected return related to prior procedure requires additional imaging in immediate postoperative period.
`59`	Distinct Procedural Service	Use when another unrelated imaging procedure is performed same day and needs to be reported separately (note: payor guidance may prefer modifier `XU`/`X5` set).
`XU`	Distinct Procedural Service (separate/anatomic)	When software or clinical circumstance demonstrates truly distinct service compared to another same-day service.
`Q0`	Investigational Device Exemption/Clinical Trial Research	When the imaging is performed as part of a qualifying clinical trial under an IDE.
`Q6`	Service Furnished Under a Research() Protocol	When the PET/CT is part of a non-IDE clinical research protocol with payer-accepted research modifier.
`GA`	Waiver of Liability Statement on File (Advance Beneficiary Notice)	When Medicare beneficiary has signed an ABN for expected non-covered service.
`GQ`	Telehealth — Asynchronous Telemedicine — Not applicable to imaging interpretation (not listed in input).	Data not available in the input.
`76`	Repeat Procedure by Same Physician	When the PET/CT (or its interpretation) is repeated by the same provider the same day.
`RT`	Right Side — Not typically applicable to whole-body PET/CT laterality but included in some modality workflows	When a laterality modifier is required by payer for a limited scan focused on one side.

Taxonomy Code	Specialty	Notes
2085P0206X	Nuclear Medicine Physician	Interprets PET/CT studies and directs radiotracer use.
2084P0800X	Diagnostic Radiology	May perform and interpret PET/CT, especially when CT is diagnostic quality.
208000000X	Internal Medicine/Oncology	Refers and uses PET/CT results for staging and treatment planning.
207RC0000X	Radiation Oncology	Uses PET/CT for treatment planning and target delineation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Common indication for whole-body PET/CT to stage lung cancer and evaluate nodal/distant metastases.
`C50.919`	Malignant neoplasm of unspecified site of unspecified female breast	PET/CT used for staging recurrent or metastatic breast cancer in select cases.
`C18.9`	Malignant neoplasm of colon, unspecified	Used to detect metastatic disease and assess metabolic activity prior to therapy.
`C61`	Malignant neoplasm of prostate	PET/CT (with prostate-specific radiotracers) is used for staging and recurrence evaluation (FDG PET less sensitive for primary prostate cancer).
`C16.9`	Malignant neoplasm of stomach, unspecified	PET/CT can assist in staging and detection of distant metastases in gastric cancer.
`C80.1`	Malignant (primary) neoplasm, unspecified	Employed when a patient has biopsy-proven malignancy without a listed primary site and needs systemic staging.
`C77.9`	Secondary and unspecified malignant neoplasm of lymph nodes	PET/CT localizes hypermetabolic nodal disease for staging and biopsy planning.
`C79.9`	Secondary malignant neoplasm of unspecified site	PET/CT identifies and characterizes suspected metastatic sites across the body.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78814`	Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; whole body, baseline	This is the primary fused PET/CT study used for staging and metabolic-anatomic localization of malignancy.
`78815`	PET with concurrently acquired CT for attenuation correction and anatomical localization; limited area (e.g., brain, heart)	Used when a targeted PET/CT of a specific region is ordered instead of whole-body imaging.
`78816`	PET with concurrently acquired diagnostic CT with contrast for attenuation correction and anatomical localization; whole body	Performed when diagnostic-quality contrast-enhanced CT is acquired during the PET/CT for comprehensive anatomic assessment.
`96372`	Therapeutic, prophylactic, or diagnostic injection (e.g., radiotracer administration)	Represents the administration of radiopharmaceuticals in some billing contexts; facility billing often includes radiotracer in technical component instead.
`74177`	Computed tomography, abdomen and pelvis; with contrast, with or without contrast material	A dedicated diagnostic CT of abdomen/pelvis may be obtained in conjunction or separately for detailed anatomic assessment.

CPT 78800: Planar Nuclear Medicine for Single–Area Tumor/Inflammation Localization

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

CPT 78801: Multi-Day/Multi-Area Nuclear Medicine Imaging

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

CPT 78802: Whole-Body Nuclear Medicine Imaging with Radiotracer

CPT-78803-SPECT-SINGLE-AREA-LOCALIZATION

CPT 78803: Single-Area SPECT for Tumor or Inflammatory Localization

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

CPT 78804: Multiday Whole-Body Nuclear Imaging with Gamma Tracer

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

CPT 78808: Intravenous Radiotracer Injection for Gamma-Probe Localization

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

CPT 78811: Targeted PET Scan of a Localized Body Region

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

CPT 78812: FDG PET Body Imaging for Oncologic Evaluation

CPT-78813-WHOLE-BODY-PET

CPT 78813: Whole-Body Positron Emission Tomography (PET)

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

CPT 78815: PET/CT Tumor Imaging for Anatomical Localization

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional Component	When billing only the physician interpretation portion of the PET/CT (technical component billed separately).
`TC`	Technical Component	When billing only the facility/technical portion (scanner, radiotracer, technologist).
`52`	Reduced Services	When the study is partially completed or limited (e.g., abbreviated protocol due to patient intolerance).
`53`	Discontinued Procedure	When the PET/CT is started but terminated due to an unforeseen complication.
`78`	Unplanned Return to OR/Productive Procedure Following Initial Service	Rare for PET/CT; used if an unexpected return related to prior procedure requires additional imaging in immediate postoperative period.
`59`	Distinct Procedural Service	Use when another unrelated imaging procedure is performed same day and needs to be reported separately (note: payor guidance may prefer modifier `XU`/`X5` set).
`XU`	Distinct Procedural Service (separate/anatomic)	When software or clinical circumstance demonstrates truly distinct service compared to another same-day service.
`Q0`	Investigational Device Exemption/Clinical Trial Research	When the imaging is performed as part of a qualifying clinical trial under an IDE.
`Q6`	Service Furnished Under a Research() Protocol	When the PET/CT is part of a non-IDE clinical research protocol with payer-accepted research modifier.
`GA`	Waiver of Liability Statement on File (Advance Beneficiary Notice)	When Medicare beneficiary has signed an ABN for expected non-covered service.
`GQ`	Telehealth — Asynchronous Telemedicine — Not applicable to imaging interpretation (not listed in input).	Data not available in the input.
`76`	Repeat Procedure by Same Physician	When the PET/CT (or its interpretation) is repeated by the same provider the same day.
`RT`	Right Side — Not typically applicable to whole-body PET/CT laterality but included in some modality workflows	When a laterality modifier is required by payer for a limited scan focused on one side.

Taxonomy Code	Specialty	Notes
2085P0206X	Nuclear Medicine Physician	Interprets PET/CT studies and directs radiotracer use.
2084P0800X	Diagnostic Radiology	May perform and interpret PET/CT, especially when CT is diagnostic quality.
208000000X	Internal Medicine/Oncology	Refers and uses PET/CT results for staging and treatment planning.
207RC0000X	Radiation Oncology	Uses PET/CT for treatment planning and target delineation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C34.90`	Malignant neoplasm of unspecified part of unspecified bronchus or lung	Common indication for whole-body PET/CT to stage lung cancer and evaluate nodal/distant metastases.
`C50.919`	Malignant neoplasm of unspecified site of unspecified female breast	PET/CT used for staging recurrent or metastatic breast cancer in select cases.
`C18.9`	Malignant neoplasm of colon, unspecified	Used to detect metastatic disease and assess metabolic activity prior to therapy.
`C61`	Malignant neoplasm of prostate	PET/CT (with prostate-specific radiotracers) is used for staging and recurrence evaluation (FDG PET less sensitive for primary prostate cancer).
`C16.9`	Malignant neoplasm of stomach, unspecified	PET/CT can assist in staging and detection of distant metastases in gastric cancer.
`C80.1`	Malignant (primary) neoplasm, unspecified	Employed when a patient has biopsy-proven malignancy without a listed primary site and needs systemic staging.
`C77.9`	Secondary and unspecified malignant neoplasm of lymph nodes	PET/CT localizes hypermetabolic nodal disease for staging and biopsy planning.
`C79.9`	Secondary malignant neoplasm of unspecified site	PET/CT identifies and characterizes suspected metastatic sites across the body.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78814`	Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; whole body, baseline	This is the primary fused PET/CT study used for staging and metabolic-anatomic localization of malignancy.
`78815`	PET with concurrently acquired CT for attenuation correction and anatomical localization; limited area (e.g., brain, heart)	Used when a targeted PET/CT of a specific region is ordered instead of whole-body imaging.
`78816`	PET with concurrently acquired diagnostic CT with contrast for attenuation correction and anatomical localization; whole body	Performed when diagnostic-quality contrast-enhanced CT is acquired during the PET/CT for comprehensive anatomic assessment.
`96372`	Therapeutic, prophylactic, or diagnostic injection (e.g., radiotracer administration)	Represents the administration of radiopharmaceuticals in some billing contexts; facility billing often includes radiotracer in technical component instead.
`74177`	Computed tomography, abdomen and pelvis; with contrast, with or without contrast material	A dedicated diagnostic CT of abdomen/pelvis may be obtained in conjunction or separately for detailed anatomic assessment.

CPT 78800: Planar Nuclear Medicine for Single–Area Tumor/Inflammation Localization

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

CPT 78801: Multi-Day/Multi-Area Nuclear Medicine Imaging

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

CPT 78802: Whole-Body Nuclear Medicine Imaging with Radiotracer

CPT-78803-SPECT-SINGLE-AREA-LOCALIZATION

CPT 78803: Single-Area SPECT for Tumor or Inflammatory Localization

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

CPT 78804: Multiday Whole-Body Nuclear Imaging with Gamma Tracer

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

CPT 78808: Intravenous Radiotracer Injection for Gamma-Probe Localization

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

CPT 78811: Targeted PET Scan of a Localized Body Region

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

CPT 78812: FDG PET Body Imaging for Oncologic Evaluation

CPT-78813-WHOLE-BODY-PET

CPT 78813: Whole-Body Positron Emission Tomography (PET)

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

CPT 78815: PET/CT Tumor Imaging for Anatomical Localization

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

OpenPayer

CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

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Billing Code Overview

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CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

Sign up for cpt 78814 policy alerts

Billing Code Overview

CPT 78814: PET/CT Fusion for Tumor Localization and Metabolic Evaluation

Sign up for cpt 78814 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 78814 represent and where is it typically performed?

Which billing modifiers are commonly used with CPT 78814 and when should they be applied?

What other CPT codes are related to 78814 and how do they differ?

Which provider specialties are involved in performing, interpreting, or using PET/CT studies billed under 78814?

What clinical indications and ICD-10 diagnoses are associated with CPT 78814 in the provided content?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 78814 represent and where is it typically performed?

Which billing modifiers are commonly used with CPT 78814 and when should they be applied?

What other CPT codes are related to 78814 and how do they differ?

Which provider specialties are involved in performing, interpreting, or using PET/CT studies billed under 78814?

What clinical indications and ICD-10 diagnoses are associated with CPT 78814 in the provided content?

References