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CPT 78265: Executing a nuclear medicine assessment of gastric emptying along with small bowel transit - Prior Authorization and Price

CPT code 78265 is Executing a nuclear medicine assessment of gastric emptying along with small bowel transit. See what Aetna, Anthem BCBS, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 78265

Executing a nuclear medicine assessment of gastric emptying along with small bowel transit.

Nuclear Medicine
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Payer guidelines that apply

PayerReviewed usingGuidelineSections
Aetna eviCore
Abdomen Imaging Guidelines 1.0.2026, effective Feb 3, 2026
Pediatric Abdomen Imaging Guidelines 2.0.2026, effective Sep 1, 2026
 2 that name this code
Anthem BCBS Carelon
Nuclear medicine imaging effective Sep 19, 2026
 1 that name this code
Cigna eviCore Current guideline None found
Medicare CMS — None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare UnitedHealthcare / eviCore 2 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Executing a nuclear medicine assessment of gastric emptying along with small bowel transit. Each has its own criteria for when the study is considered appropriate.

  • Bowel Obstruction, Gastroparesis, and Bloating Aetna · UnitedHealthcare
  • Gastrointestinal motility, including gastric outlet obstruction and gastroparesis Anthem BCBS

Typical price

Commercial insurance, median
$642
Middle half of rates: $487 to $1,023
Medicare, hospital outpatient
$408
Facility payment
Medicare, physician fee schedule
$349
National, non-facility

Commercial figures come from negotiated rates published by 532 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Executing a nuclear medicine assessment of gastric emptying along with small bowel transit change.

Frequently asked questions

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