CPT 78305Radiology

Bone imaging multiple areas

CPT code 78305 is used when a patient receives a nuclear medicine bone scan that examines multiple areas of the skeleton at once, typically to detect abnormalities like fractures, infections, or cancer spread to bones.

Showing rates for

National Average

Base Medicare rate

$239.69

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

0.83

PE RVU (NF)

6.5

MP RVU

0.08

Total RVU

7.41

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Document all anatomical areas imaged specifically in the report (spine, pelvis, ribs, extremities, etc.) to support 'multiple areas' requirement
Impact: Prevents downcoding to single-area codes like 78300, which would reduce reimbursement by approximately $100-150
Verify that imaging protocol includes at least two distinct skeletal regions; whole-body imaging automatically qualifies
Impact: Ensures full $239.69 Medicare payment versus denial or incorrect coding
Bill injection code 78808 separately when radiopharmaceutical administration is performed but imaging is delayed to next calendar day
Impact: Captures additional reimbursement of approximately $30-40 for the injection service
Do not report 78305 with SPECT bone imaging codes (78320) for the same anatomical areas on same date of service
Impact: Prevents bundling denials and potential audit flags for unbundling; SPECT codes are more comprehensive and replace planar imaging
For Medicare patients, ensure medical necessity is documented with appropriate ICD-10 codes such as bone pain, cancer staging, or suspected metastases
Impact: Reduces denial rate by 30-40% and supports LCD/NCD compliance for nuclear medicine procedures
Submit claims with place of service code 22 (hospital outpatient) or 11 (office) depending on actual location, as facility status affects cost-sharing
Impact: While Medicare pays $239.69 in both settings for this code, incorrect POS may trigger patient liability issues

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 78305?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 78305 in 2025?

The 2025 Medicare national average reimbursement for CPT 78305 is $239.69 for both facility and non-facility settings, based on 7.41 total RVUs and the conversion factor of 32.3465.

How many areas must be imaged to bill CPT 78305 instead of 78300?

CPT 78305 requires imaging of multiple distinct skeletal areas (typically 2 or more separate regions such as spine and pelvis, or a whole-body scan). Single limited area imaging should be reported with 78300. Comprehensive whole-body bone scans automatically qualify for 78305.

Can CPT 78305 be billed with SPECT bone imaging on the same day?

No, CPT 78305 should not be billed with SPECT bone codes (78320) for the same anatomical areas on the same date of service. SPECT imaging is a more advanced technique that includes planar imaging, so billing both would constitute unbundling and result in denial.

What modifiers are most commonly used with CPT 78305?

Modifiers 26 (professional component only) and TC (technical component only) are most common when splitting billing between interpreting physician and imaging facility. Modifier 59 may be appropriate when billing with other procedures to indicate distinct services.

How long should patients wait between bone scan injection and imaging for CPT 78305?

Standard protocol requires 2-4 hours between radiopharmaceutical injection and image acquisition to allow adequate bone uptake and soft tissue clearance. If imaging occurs on a different calendar day than injection, the injection may be separately billable with code 78808.

What are the work RVUs for CPT 78305 in 2025?

CPT 78305 has 0.83 work RVUs, 6.5 practice expense RVUs (both facility and non-facility), and 0.08 malpractice RVUs, totaling 7.41 RVUs for 2025 according to the CMS Physician Fee Schedule.

What diagnoses typically support medical necessity for CPT 78305?

Common supporting diagnoses include cancer staging/metastatic workup (C79.51), bone pain (M79.9), pathological fracture (M84.4), osteomyelitis (M86), elevated alkaline phosphatase (R74.8), and Paget's disease (M88). Documentation must clearly link the diagnosis to the need for multi-area skeletal imaging.