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CPT 78650: Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection - Prior Authorization and Price

CPT code 78650 is Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection. See what Aetna, Anthem BCBS, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 78650

Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection.

Nuclear Medicine
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Payer guidelines that apply

PayerReviewed usingGuidelineSections
Aetna eviCore
Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026
Pediatric Head Imaging Guidelines 2.0.2026, effective Sep 1, 2026
 2 that name this code
Anthem BCBS Carelon
Nuclear medicine imaging effective Sep 19, 2026
 4 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 Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection. Each has its own criteria for when the study is considered appropriate.

  • Brain and spinal cord malignancies Anthem BCBS
  • Cerebrospinal fluid leak of the skull base Anthem BCBS
  • Hydrocephalus/ventricular assessment, when MRI cannot be performed or is nondiagnostic Anthem BCBS
  • Spontaneous (idiopathic) intracranial hypotension, when MRI cannot be performed or is nondiagnostic Anthem BCBS
  • Nuclear Medicine Aetna · UnitedHealthcare

Typical price

Commercial insurance, median
$1,561
Middle half of rates: $1,018 to $2,055
Medicare, hospital outpatient
$1,323
Facility payment
Medicare, physician fee schedule
$246
National, non-facility

Commercial figures come from negotiated rates published by 595 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 Conducting a nuclear medicine study to assess cerebrospinal fluid flow for leakage detection change.

Frequently asked questions

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