78815
PET-CT, skull to mid-thigh
Positron emission tomography with concurrent computed tomography (PET-CT), skull base to mid-thigh. CMS 2026 global wRVU 1.94, total RVU approximately 12.57, Medicare global allowable approximately $420. The standard oncology staging and surveillance PET-CT field; covers nearly all adult-cancer indications.
Billing guidance for 78815 is locked
- When to use it: the exact clinical situations that support billing 78815
- Documentation checklist: the 6 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 78815 downcoded or denied
Payer notes
Medicare covers 78815 for FDA-approved oncology indications under National Coverage Determination. Initial diagnosis (staging) is covered for nearly all solid tumors; surveillance frequency varies by cancer type and NCCN guidelines. Commercial payers require prior authorization. Non-oncology indications (cardiac viability, infection, inflammation) are covered under different criteria — typically the dedicated cardiac PET codes (78429-78433) rather than 78815.