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CPT code 78120: Red cell mass, single determination2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $85.24 for 78120 in the office.

$85.24Office (non-facility)
Not available in this settingHospital or facility
+17.6%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $85.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

78120 in Queens, NY vs other payment areas
  1. Queens, NY · this page$85.24
  2. Manhattan, NY · New York$84.21−$1.03
  3. NYC suburbs and Long Island, NY · New York$86.38+$1.14
  4. Poughkeepsie and northern NYC suburbs, NY · New York$79.19−$6.05
  5. Rest of New York · New York$68.81−$16.43
  6. Los Angeles, CA · California$83.83−$1.41
  7. Washington, DC area · District of Columbia$84.36−$0.88

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

78120 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$77.64—
Chicago, ILIllinois$75.01—
AlaskaAlaska$79.53—
AlabamaAlabama$63.82—
ArkansasArkansas$62.72—
ArizonaArizona$70.27—
Bakersfield, CACalifornia$78.06—
Chico, 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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 78120 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.22× 1.0640.2341
Practice expense1.90× 1.1822.2458
Malpractice0.05× 1.4420.0721
Total RVUs2.5520
Conversion factor× 33.4009

Office rate, Queens, NY$85.24

Office: (0.22 × 1.064 + 1.9 × 1.182 + 0.05 × 1.442) × $33.4009 = $85.24

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, Queens, NY
Often billed with
78110Plasma volume, single sampleSingle plasma volume measurement may be performed alongside red cell mass assessment.$83.78
Same family
78121Red cell mass, multiple determinationsSibling code for a red cell mass study involving multiple determinations.$114.49
Used instead
78122Blood volume test, whole blood determinationUsed when the study determines whole blood volume rather than red cell mass alone.$118.41

How 78120 has changed in Queens, NY

78120 · Office / nonfacility

$85.24

Effective 2026-10-01

The base rate is $3.06 higher than on 2025-10-01, moving from $82.18 to $85.24 (3.7%).

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

    $82.18changed to$85.24

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $83.78changed to$82.18

    • 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

    $82.41changed to$83.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $86.92changed to$82.41

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.83 changed to 1.84
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $91.20changed to$86.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.84 changed to 1.83
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $91.53changed to$91.20

    • 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

    $89.75changed to$91.53

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $88.32changed to$89.75

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $96.44changed to$88.32

    • 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

    $118.15changed to$96.44

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.47 changed to 1.96
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $117.39changed to$118.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.46 changed to 2.47
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $117.03changed to$117.39

    • 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

    $116.45changed to$117.03

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $115.97changed to$116.45

    • 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 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $111.17changed to$115.97

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.48 changed to 2.44
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $111.17

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$85.24Not available in this settingRVU26D
2026-07-01$85.24Not available in this settingRVU26C
2026-04-01$85.24Not available in this settingRVU26B
2026-01-01$85.24Not available in this settingRVU26A
2025-10-01$82.18Not available in this settingRVU25D
2025-07-01$82.18Not available in this settingRVU25C
2025-04-01$82.18Not available in this settingRVU25B
2025-01-01$82.18Not available in this settingRVU25A
2024-10-01$83.78Not available in this settingRVU24D
2024-07-01$83.78Not available in this settingRVU24C
2024-04-01$83.78Not available in this settingRVU24B
2024-03-09$83.78Not available in this settingRVU24AR
2024-01-01$82.41Not available in this settingRVU24A
2023-10-01$86.92Not available in this settingRVU23D
2023-07-01$86.92Not available in this settingRVU23C
2023-04-01$86.92Not available in this settingRVU23B
2023-01-01$86.92Not available in this settingRVU23A
2022-10-01$91.20Not available in this settingRVU22D
2022-07-01$91.20Not available in this settingRVU22C
2022-04-01$91.20Not available in this settingRVU22B
2022-01-01$91.20Not available in this settingRVU22A
2021-10-01$91.53Not available in this settingRVU21D
2021-07-01$91.53Not available in this settingRVU21C
2021-04-01$91.53Not available in this settingRVU21B
2021-01-01$91.53Not available in this settingRVU21A
2020-10-01$89.75Not available in this settingRVU20D
2020-07-01$89.75Not available in this settingRVU20C
2020-04-01$89.75Not available in this settingRVU20B
2020-01-01$89.75Not available in this settingRVU20A
2019-10-01$88.32Not available in this settingRVU19D
2019-07-01$88.32Not available in this settingRVU19C
2019-04-01$88.32Not available in this settingRVU19B
2019-01-01$88.32Not available in this settingRVU19A
2018-10-01$96.44Not available in this settingRVU18D
2018-07-01$96.44Not available in this settingRVU18C
2018-04-01$96.44Not available in this settingRVU18B
2018-01-01$96.44Not available in this settingRVU18AR1
2017-10-01$118.15Not available in this settingRVU17D
2017-07-01$118.15Not available in this settingRVU17C
2017-04-01$118.15Not available in this settingRVU17B
2017-01-01$118.15Not available in this settingRVU17A
2016-10-01$117.39Not available in this settingRVU16D
2016-07-01$117.39Not available in this settingRVU16C
2016-04-01$117.39Not available in this settingRVU16B
2016-01-01$117.39Not available in this settingRVU16A
2015-10-01$117.03Not available in this settingRVU15D
2015-07-01$117.03Not available in this settingRVU15C
2015-04-01$116.45Not available in this settingRVU15B
2015-01-01$116.45Not available in this settingRVU15A
2014-10-01$115.97Not available in this settingRVU14D
2014-07-01$115.97Not available in this settingRVU14C
2014-04-01$115.97Not available in this settingRVU14B
2014-01-01$115.97Not available in this settingRVU14A
2013-10-01$111.17Not available in this settingRVU13D
2013-07-01$111.17Not available in this settingRVU13C
2013-04-01$111.17Not available in this settingRVU13B
2013-01-01$111.17Not available in this settingRVU13AR

Price 78120 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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