Price Checker / CPT 78216
CPT 78216 — Lvr&spleen img w/vasc flow
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$132
What Medicare pays in a hospital/ASC setting
$132
What Medicare pays in a physician's office
$2,969
Based on 9 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 78216
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Minden Medical Center , LA | $5,142 | $1,543 | 3798% |
| PAM Rehabilitation Hospital of Tulsa , OK | $3,905 | $3,905 | 2860% |
| Mercy Hospital Lebanon , AR | $3,147 | $2,046 | 2285% |
| Franciscan Healthcare , NE | $2,671 | $2,671 | 1925% |
| Sanford Vermillion Hospital , SD | $2,454 | $1,963 | 1760% |
| Sanford Hospital Webster , SD | $2,442 | $1,954 | 1751% |
| Butler County Health , NE | $2,398 | $2,398 | 1718% |
| Sedgwick County Health Center , CO | $2,398 | $2,398 | 1718% |
| Morrill County Community Hospital , NE | $2,165 | $2,035 | 1541% |
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About CPT 78216
CPT code 78216 refers to “Lvr&spleen img w/vasc flow”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $132 in a facility (hospital or ambulatory surgery center) and $132in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.