CPT 78701Radiology

Kidney imaging with flow

CPT code 78701 covers a nuclear medicine scan that takes pictures of your kidneys while tracking blood flow through them using a radioactive tracer. This test helps doctors see how well blood is reaching your kidneys and identify blockages or circulation problems.

Showing rates for

National Average

Base Medicare rate

$199.25

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

0.49

PE RVU (NF)

5.61

MP RVU

0.06

Total RVU

6.16

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Always document both the dynamic flow phase (first 1-2 minutes) and the subsequent morphologic imaging phases separately in the report
Impact: Prevents downcoding to 78700 (without flow) which reimburses lower; documentation must explicitly reference arterial flow assessment to justify 78701
Bill professional and technical components separately when applicable - verify your facility's arrangement with Medicare
Impact: Proper component billing ensures full $199.25 reimbursement is split appropriately; incorrect billing can result in 50% or more payment loss
Document radiopharmaceutical type, dose administered in mCi/MBq, administration time, and any adverse reactions
Impact: Required for compliance and medical necessity; missing radiopharmaceutical documentation is a top audit trigger with potential 100% recoupment
Ensure time-activity curves or quantitative flow data are included when clinically indicated, especially for transplant evaluation
Impact: Strengthens medical necessity for repeat studies; quantitative data may justify additional reimbursement in some commercial contracts
Check NCCI edits before billing 78701 with same-day renal function studies (78707-78709) - may require modifier 59
Impact: Prevents automatic denials; improper modifier use delays payment by 30-45 days during appeal process
For kidney transplant patients, link diagnosis codes specifically indicating transplant status (Z94.0) and reason for evaluation
Impact: Improves first-pass payment rate by 25-30% for transplant-related imaging; generic kidney disease codes trigger higher denial rates

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 78701?

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 78701 in 2025?

The 2025 Medicare national average reimbursement for CPT 78701 is $199.25 for both facility and non-facility settings. This rate is based on 6.16 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

What is the difference between CPT 78701 and 78700?

CPT 78701 includes kidney imaging with vascular flow study, capturing the dynamic arterial perfusion phase, while 78700 is kidney imaging without flow assessment. Code 78701 requires documentation of both the flow phase (dynamic imaging during tracer arrival) and morphologic imaging, justifying the higher reimbursement and RVU value.

Can CPT 78701 be billed bilaterally or with RT/LT modifiers?

CPT 78701 is inherently a bilateral procedure that includes imaging of both kidneys when present. RT/LT modifiers can be appended for documentation purposes when only one kidney is imaged (due to prior nephrectomy or focused clinical question), but Medicare typically does not adjust reimbursement for unilateral kidney imaging as the technical work and radiopharmaceutical dose remain the same.

How often can CPT 78701 be billed for the same patient?

Medicare does not impose specific frequency limitations on CPT 78701, but medical necessity must be documented for each study. Repeat imaging within 3 months typically requires documentation of clinical change, treatment intervention, or new symptoms. Routine surveillance imaging in transplant patients is generally accepted at 3-6 month intervals depending on clinical status and local coverage determinations.

What diagnosis codes support medical necessity for CPT 78701?

Common supporting diagnoses include renal artery stenosis (I70.1), kidney transplant status (Z94.0), acute kidney injury (N17.9), chronic kidney disease stages (N18.x), suspected renal artery occlusion (I70.1), hypertension with suspected renovascular cause (I15.0), and transplant complications (T86.1x). The diagnosis must support the need for flow assessment versus standard imaging.

Do I need to bill the radiopharmaceutical separately from CPT 78701?

In most settings, radiopharmaceutical costs are included in the technical component of CPT 78701 and should not be billed separately to Medicare. Hospital outpatient departments may report radiopharmaceuticals with HCPCS codes on the UB-04 for cost accounting, but these are not separately reimbursed. Some commercial payers may allow separate radiopharmaceutical billing - verify payer-specific policies.

What are the Work RVUs and PE RVUs for CPT code 78701?

For 2025, CPT 78701 has 0.49 Work RVUs, 5.61 Practice Expense RVUs (both facility and non-facility), and 0.06 Malpractice RVUs, totaling 6.16 RVUs. The identical facility and non-facility PE RVUs reflect that this procedure is typically performed in facility settings with similar resource requirements regardless of location.