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CPT code 78120: Red cell mass, single determination2026 Medicare rate & RVUs in Washington, DC area

Reports a nuclear medicine study that measures circulating red cell mass in one determination, often to assess erythrocytosis or polycythemia.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $84.36 for 78120 in the office.

$84.36Office (non-facility)
Not available in this settingHospital or facility
+16.4%vs the national office rate ($72.48)

Check a contract rate as a % of Medicare · 78120 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 78120 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 78120 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 78120 covers

This nuclear medicine study measures the patient’s circulating red cell mass using labeled red cells and blood sampling. It may be ordered when a clinician needs to determine whether an elevated hematocrit reflects increased red cell mass, as in evaluation of erythrocytosis or suspected polycythemia, rather than a change in plasma volume. Nuclear medicine personnel typically perform the technical work, with a qualified practitioner interpreting the results. The study may be performed in a hospital or an outpatient nuclear medicine department.

Report 78120 for a single red cell mass determination; the distinction from 78121 is whether the study includes multiple determinations. Documentation should identify the red cell mass study and support the single-determination service. Medicare recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Red cell mass may be assessed with a separate plasma volume study when both measurements are performed and documented.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 78120

Across 109 of 109 payment localities, the office rate for 78120 runs from $62.72 in Arkansas to $100.56 in San Benito County, CA. Washington, DC area pays $84.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

78120 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$84.36
  2. Los Angeles, CA · California$83.83−$0.53
  3. Miami, FL · Florida$77.64−$6.72
  4. Chicago, IL · Illinois$75.01−$9.35
  5. Manhattan, NY · New York$84.21−$0.15
  6. Alaska · Alaska$79.53−$4.83
  7. Alabama · Alabama$63.82−$20.54

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

78120 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$62.72—
ArizonaArizona$70.27—
Bakersfield, CACalifornia$78.06—
Chico, CACalifornia$77.92—
El Centro, CACalifornia$77.93—
Fresno, CACalifornia$77.92—
Hanford, CACalifornia$77.92—
Madera, CACalifornia$77.92—

78120 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$62.72

$89.24

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78120 office rate range by state
State / territoryOffice rate rangeLocalities
AK$79.531
AL$63.821
AR$62.721
AZ$70.271
CA$77.92–$100.5629
CO$76.261
CT$77.861
DC$84.361
DE$71.591
FL$70.53–$77.643
GA$65.95–$73.852
GU$80.471
HI$80.471
IA$66.081
ID$66.521
IL$67.90–$75.534
IN$66.991
KS$65.561
KY$65.291
LA$65.11–$68.962
MA$75.62–$84.912
MD$73.18–$84.363
ME$66.77–$71.292
MI$67.17–$71.402
MN$73.141
MO$63.68–$69.443
MS$63.221
MT$72.481
NC$67.631
ND$71.491
NE$66.551
NH$74.871
NJ$78.77–$83.212
NM$67.551
NV$72.261
NY$68.81–$86.385
OH$66.971
OK$65.321
OR$71.73–$79.212
PA$67.18–$75.542
PR$73.151
RI$74.531
SC$67.411
SD$71.371
TN$65.931
TX$66.65–$75.998
UT$68.501
VA$70.91–$84.362
VI$73.151
VT$71.021
WA$75.54–$86.952
WI$68.661
WV$64.891
WY$72.051

See 78120 in every payment locality

How the 78120 rate is calculated

Each of 78120’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 78120

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.22

0.22 RVUs× 1.000 GPCI

Practice expense1.90

1.90 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.1700

Conversion factor

$33.4009

Medicare rate

$72.48

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,230

Code
78120
Physician work
0.22
Practice expense
1.90
Malpractice
0.05

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 78120 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.22× 1.0540.2319
Practice expense1.90× 1.1782.2382
Malpractice0.05× 1.1130.0557
Total RVUs2.5257
Conversion factor× 33.4009

Office rate, Washington, DC area$84.36

Office: (0.22 × 1.054 + 1.9 × 1.178 + 0.05 × 1.113) × $33.4009 = $84.36

Open 78120 in the RVU calculator

Payment rules and modifiers for 78120

The CMS indicators that decide how 78120 is paid alongside other services.

CMS payment indicators · 78120

Red cell mass, single determination

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78120 without 26 · national office

$72.48

Red cell mass, single determination

78120-26 · Professional component

$9.02

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78120

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78120
CodeHow it relatesOffice range, Washington, DC area
Often billed with
78110Plasma volume, single sampleSingle plasma volume measurement may be performed alongside red cell mass assessment.$82.91
Same family
78121Red cell mass, multiple determinationsSibling code for a red cell mass study involving multiple determinations.$113.50
Used instead
78122Blood volume test, whole blood determinationUsed when the study determines whole blood volume rather than red cell mass alone.$117.27

How 78120 has changed in Washington, DC area

78120 · Office / nonfacility

$84.36

Effective 2026-10-01

The base rate is $2.89 higher than on 2025-10-01, moving from $81.47 to $84.36 (3.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $81.47changed to$84.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.23 changed to 0.22
    • Practice expense RVU 1.86 changed to 1.90
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $83.05changed to$81.47

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.84 changed to 1.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $81.69changed to$83.05

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $85.60changed to$81.69

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.83 changed to 1.84
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $89.33changed to$85.60

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.84 changed to 1.83
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $89.64changed to$89.33

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.83 changed to 1.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $88.55changed to$89.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.77 changed to 1.83
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $87.35changed to$88.55

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $95.49changed to$87.35

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.96 changed to 1.77

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $117.29changed to$95.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.47 changed to 1.96
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $116.62changed to$117.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.46 changed to 2.47
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $116.58changed to$116.62

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.03 changed to 0.04

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $116.00changed to$116.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $115.44changed to$116.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.44 changed to 2.46
    • Malpractice RVU 0.04 changed to 0.03
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $110.83changed to$115.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.48 changed to 2.44
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $110.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$84.36Not available in this settingRVU26D
2026-07-01$84.36Not available in this settingRVU26C
2026-04-01$84.36Not available in this settingRVU26B
2026-01-01$84.36Not available in this settingRVU26A
2025-10-01$81.47Not available in this settingRVU25D
2025-07-01$81.47Not available in this settingRVU25C
2025-04-01$81.47Not available in this settingRVU25B
2025-01-01$81.47Not available in this settingRVU25A
2024-10-01$83.05Not available in this settingRVU24D
2024-07-01$83.05Not available in this settingRVU24C
2024-04-01$83.05Not available in this settingRVU24B
2024-03-09$83.05Not available in this settingRVU24AR
2024-01-01$81.69Not available in this settingRVU24A
2023-10-01$85.60Not available in this settingRVU23D
2023-07-01$85.60Not available in this settingRVU23C
2023-04-01$85.60Not available in this settingRVU23B
2023-01-01$85.60Not available in this settingRVU23A
2022-10-01$89.33Not available in this settingRVU22D
2022-07-01$89.33Not available in this settingRVU22C
2022-04-01$89.33Not available in this settingRVU22B
2022-01-01$89.33Not available in this settingRVU22A
2021-10-01$89.64Not available in this settingRVU21D
2021-07-01$89.64Not available in this settingRVU21C
2021-04-01$89.64Not available in this settingRVU21B
2021-01-01$89.64Not available in this settingRVU21A
2020-10-01$88.55Not available in this settingRVU20D
2020-07-01$88.55Not available in this settingRVU20C
2020-04-01$88.55Not available in this settingRVU20B
2020-01-01$88.55Not available in this settingRVU20A
2019-10-01$87.35Not available in this settingRVU19D
2019-07-01$87.35Not available in this settingRVU19C
2019-04-01$87.35Not available in this settingRVU19B
2019-01-01$87.35Not available in this settingRVU19A
2018-10-01$95.49Not available in this settingRVU18D
2018-07-01$95.49Not available in this settingRVU18C
2018-04-01$95.49Not available in this settingRVU18B
2018-01-01$95.49Not available in this settingRVU18AR1
2017-10-01$117.29Not available in this settingRVU17D
2017-07-01$117.29Not available in this settingRVU17C
2017-04-01$117.29Not available in this settingRVU17B
2017-01-01$117.29Not available in this settingRVU17A
2016-10-01$116.62Not available in this settingRVU16D
2016-07-01$116.62Not available in this settingRVU16C
2016-04-01$116.62Not available in this settingRVU16B
2016-01-01$116.62Not available in this settingRVU16A
2015-10-01$116.58Not available in this settingRVU15D
2015-07-01$116.58Not available in this settingRVU15C
2015-04-01$116.00Not available in this settingRVU15B
2015-01-01$116.00Not available in this settingRVU15A
2014-10-01$115.44Not available in this settingRVU14D
2014-07-01$115.44Not available in this settingRVU14C
2014-04-01$115.44Not available in this settingRVU14B
2014-01-01$115.44Not available in this settingRVU14A
2013-10-01$110.83Not available in this settingRVU13D
2013-07-01$110.83Not available in this settingRVU13C
2013-04-01$110.83Not available in this settingRVU13B
2013-01-01$110.83Not available in this settingRVU13AR

Price 78120 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

78120 billing questions

When should 78120 be chosen instead of 78121?

Use 78120 for a single red cell mass determination. Use 78121 when the study includes multiple determinations.

Can a plasma volume study be reported with 78120?

Yes, when a plasma volume study is also performed and documented. Code 78110 describes a single plasma volume determination.

How are the professional and technical services reported?

Use modifier 26 for the interpretation and modifier TC for the equipment and staff. Without a component modifier, the claim represents the global service.

What documentation supports reporting 78120?

Document the red cell mass study performed and that it involved a single determination. The record should support the interpretation or technical work billed.

Does 78120 measure total blood volume?

No. It measures red cell mass; 78122 is the code for whole blood volume determination.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 78120PPRRVU2026_Oct_nonQPP.csv, line 9,230 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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