Insurance Reimbursement and Billing Codes

This procedure is generally covered by Medicare/Medicaid, and most private carriers. Insurance reimbursement is attained through standard nuclear medicine CPT codes.

Average reimbursement rates range from $200 to $700 depending on geographic region and payers' policies for reimbursement.

Billing Codes

For Breast Tumor Imaging Procedures & Imaging Agent
  • 78800 - Tumor localization (limited area)
  • 78801 - Tumor localization (multiple areas)
  • A9500 - Imaging agent; Technetium TC 99M Sestamibi (formerly trade named Miraluma)
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