CPT 78071Radiology

Parathyrd planar w/wo subtrj

CPT code 78071 covers parathyroid imaging using nuclear medicine techniques to locate abnormal parathyroid glands. This planar scan uses radioactive tracers to identify overactive parathyroid tissue that may be causing elevated calcium levels.

Showing rates for

National Average

Base Medicare rate

$304.70

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.2

PE RVU (NF)

8.13

MP RVU

0.09

Total RVU

9.42

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Ensure clear documentation distinguishes 78071 (planar only) from 78072 (SPECT with subtraction) as many facilities default to SPECT imaging which requires the higher code
Impact: Prevents downcoding from 78072 to 78071, preserving approximately $100-150 difference in reimbursement when SPECT is actually performed
Document the specific radiopharmaceutical used (Tc-99m sestamibi vs dual-isotope protocol), dosage, and timing of imaging phases as required for medical necessity justification
Impact: Reduces denial rate by 30-40% for medical necessity challenges and supports coverage determination
Bill 78071 globally unless there is a clear split between technical and professional components; split billing requires modifier 26/TC and separate agreements
Impact: Maximizes reimbursement at full $304.70 rate versus risking underpayment if components are incorrectly split
Verify pre-authorization requirements as many commercial payers require prior authorization for parathyroid imaging despite Medicare not requiring it
Impact: Prevents denials on 15-25% of commercial claims that would otherwise require lengthy appeals process
When billing with same-day thyroid studies, document separate medical necessity for each study and apply modifier 59 to prevent bundling denials
Impact: Preserves additional $200-300 in reimbursement for the separate thyroid study that would otherwise be bundled
Ensure the supervising physician's interpretation includes specific mention of planar technique, number of views, timing intervals, and whether subtraction images were used

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 78071?

The 2025 Medicare national average payment rate for CPT 78071 is $304.70 for both facility and non-facility settings. This is based on 9.42 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary based on geographic adjustment factors (GPCI) applied to your specific locality.

What is the difference between CPT 78071 and 78072 for parathyroid imaging?

CPT 78071 covers planar parathyroid imaging only (two-dimensional images), while CPT 78072 includes SPECT (single photon emission computed tomography) with subtraction, which provides three-dimensional cross-sectional images. Code 78072 cannot be billed in addition to 78071; use only the code that accurately reflects the imaging technique actually performed. SPECT imaging (78072) typically has higher reimbursement due to increased technical complexity.

Does CPT 78071 require prior authorization from Medicare?

Traditional Medicare does not typically require prior authorization for CPT 78071, though some Medicare Advantage plans may require it. However, documentation of medical necessity (elevated PTH and calcium levels indicating hyperparathyroidism) must be present in the medical record. Always verify specific payer requirements as commercial insurance and Medicare Advantage plans frequently require prior authorization for nuclear medicine studies.

Can CPT 78071 be billed with a thyroid scan on the same day?

Yes, CPT 78071 can be billed with thyroid scan codes (78013, 78014) on the same day when there is distinct medical necessity for both procedures, but modifier 59 should be appended to the secondary procedure to prevent bundling denials. Documentation must clearly support the need for separate parathyroid and thyroid evaluation, such as coexisting thyroid pathology requiring independent assessment.

What documentation is required to bill CPT 78071 for parathyroid imaging?

Required documentation includes: indication with biochemical evidence of hyperparathyroidism (PTH and calcium lab values), radiopharmaceutical type and dose, specific imaging protocol identifying planar technique, timing of image phases, anatomical findings, correlation with clinical history, and a signed physician interpretation explicitly stating planar imaging was performed. Supervision documentation and physician credentials should be available for audit purposes.

How many RVUs is CPT code 78071 worth in 2025?

CPT 78071 has 9.42 total RVUs in 2025, composed of 1.2 work RVUs, 8.13 practice expense RVUs (both facility and non-facility), and 0.09 malpractice RVUs. These RVU values are the same for both facility and non-facility settings, which is reflected in the identical Medicare payment rate of $304.70 for both settings.

What are common denial reasons for CPT 78071 and how can they be prevented?

Common denials include lack of documented medical necessity (missing PTH/calcium lab values), bundling with thyroid scans without modifier 59, incorrect code selection when SPECT was actually performed (should be 78072), and supervision requirement issues. Prevent denials by ensuring complete lab documentation, using appropriate modifiers, accurately coding the imaging technique performed, and maintaining proper physician supervision and interpretation documentation.