CPT code 78191: Platelet study, platelet survival2026 Medicare rate & RVUs

Reports a study that measures platelet survival over time to investigate shortened platelet lifespan or suspected platelet destruction and sequestration.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $126.92 for 78191 nationally in the office. Local office rates run $111.00–$174.36.

Medicare rate · 78191

Platelet study, platelet survival

Office or facility?

Work RVUs
0.59
Total RVUs
3.80
Global days
XXX

National rate · 2026

$126.92

Office setting, before claim adjustments.

See every locality for 78191 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 78191 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78191 covers

This diagnostic study evaluates how long platelets remain in circulation and may help investigate thrombocytopenia when shortened survival or sequestration is suspected. It involves studying the patient’s platelets over time; nuclear medicine and laboratory personnel may perform the technical work, while a physician interprets the findings. The study is distinct from imaging the spleen alone and from tests that track red blood cells.

Report 78191 for the platelet-survival study as a whole, supported by the order, records of the study performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation and a technical component for equipment and staff. Bill the professional work with modifier 26, the technical work with modifier TC, or the global service without either modifier when one entity provides both components. The documentation should identify the clinical question and support the component billed.

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.

Where 78191 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$111.00 to $174.36

$111.00$142.68$174.36
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

78191 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$112.80Unavailable
Alaska$142.54Unavailable
Arizona$123.34Unavailable
Arkansas$111.00Unavailable
Atlanta, GA$129.13Unavailable
Austin, TX$132.78Unavailable
Bakersfield, CA$136.45Unavailable
Baltimore area, MD$135.45Unavailable
Beaumont, TX$117.32Unavailable
Brazoria, TX$125.62Unavailable

78191 rates by state

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

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.

$111.00

$155.30

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

View every state and territory as a table
78191 office rate range by state
State / territoryOffice rate rangeLocalities
AK$142.541
AL$112.801
AR$111.001
AZ$123.341
CA$136.24–$174.3629
CO$133.361
CT$135.881
DC$146.921
DE$125.531
FL$123.48–$134.803
GA$116.05–$129.132
GU$140.311
HI$140.311
IA$116.601
ID$117.301
IL$119.12–$131.704
IN$118.071
KS$115.701
KY$115.081
LA$114.76–$121.052
MA$132.32–$147.822
MD$128.19–$146.923
ME$117.65–$125.122
MI$118.10–$124.862
MN$128.321
MO$112.39–$121.893
MS$111.741
MT$126.921
NC$119.051
ND$125.531
NE$117.391
NH$130.931
NJ$137.59–$145.102
NM$118.691
NV$126.641
NY$120.99–$150.015
OH$117.821
OK$115.181
OR$125.81–$138.282
PA$118.19–$132.032
PR$128.041
RI$130.511
SC$118.601
SD$125.371
TN$116.301
TX$117.32–$132.788
UT$120.391
VA$124.45–$146.922
VI$128.041
VT$124.721
WA$132.18–$151.292
WI$120.901
WV$114.191
WY$126.321

How the 78191 rate is calculated

Each of 78191’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 · 78191

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense3.14

3.14 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.8000

Conversion factor

$33.4009

Medicare rate

$126.92

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

Payment rules and modifiers for 78191

The CMS indicators that decide how 78191 is paid alongside other services.

CMS payment indicators · 78191

Platelet study, platelet survival

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

78191 without 26 · national office

$126.92

Platelet study, platelet survival

78191-26 · Professional component

$23.71

Pays only the interpretation and report.

When to use modifier 26

78191 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78191

    Platelet study, platelet survival0.59 wRVU

    $126.92

  • 78130

    Red-cell survival, erythrocyte lifespan0.59 wRVU

    $126.92+$0.00

  • 78140

    Red-cell study, splenic sequestration0.59 wRVU

    $109.89−$17.03

  • 78185

    Spleen imaging, radionuclide study0.39 wRVU

    $154.31+$27.39

How to choose

78130Red-cell survivalErythrocyte lifespan
Choose 78191 for platelet survival and 78130 for red-cell survival; the tracked blood-cell type distinguishes the studies.
78140Red-cell studySplenic sequestration
78191 evaluates platelet survival, while 78140 evaluates red-cell sequestration.
78185Spleen imagingRadionuclide study
78191 studies platelet survival over time. 78185 reports spleen imaging, not platelet-survival measurement.

78191 billing questions

How is 78191 different from a red-cell survival study?

78191 evaluates platelet survival. Use 78130 when the study tracks red-cell survival instead.

When should modifier 26 or TC be reported?

Use modifier 26 for the physician’s interpretation and modifier TC for the technical component. Report the global service without either modifier when both components are billed together.

What documentation supports the professional component?

The record should include the clinical question and the physician’s interpretation of the platelet-survival findings.

Does the technical component include the interpretation?

No. CMS identifies equipment and staff as the technical component; physician interpretation is the professional component.

Is this the code for spleen imaging?

No. 78191 evaluates platelet survival. 78185 is the spleen-imaging code when the service performed is imaging the spleen.

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 78191PPRRVU2026_Oct_nonQPP.csv, line 9,248 (RVU26D)

Open CMS sourceHow we calculate rates

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