CPT code 78191: Platelet study, platelet survival2026 Medicare rate & RVUs in Merced, CA
Reports a study that measures platelet survival over time to investigate shortened platelet lifespan or suspected platelet destruction and sequestration.
In Merced, CA, Medicare pays $136.24 for 78191 in the office.
Check a contract rate as a % of Medicare · 78191 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Merced, CA compares for 78191
Across 109 of 109 payment localities, the office rate for 78191 runs from $111.00 in Arkansas to $174.36 in San Benito County, CA. Merced, CA pays $136.24. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Merced, CA · this page$136.24
- Bakersfield, CA · California$136.45+$0.21
- Chico, CA · California$136.24
- El Centro, CA · California$136.25+$0.01
- Fresno, CA · California$136.24
- Hanford, CA · California$136.24
- Los Angeles, CA · California$146.14+$9.90
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $136.24 | — |
| Modesto, CACalifornia | $136.24 | — |
| Napa, CACalifornia | $160.37 | — |
| Oxnard, CACalifornia | $145.68 | — |
| Redding, CACalifornia | $136.24 | — |
| Rest of CaliforniaCalifornia | $136.24 | — |
| Riverside, CACalifornia | $137.00 | — |
| Sacramento, CACalifornia | $143.64 | — |
| Salinas, CACalifornia | $143.13 | — |
| San Diego, CACalifornia | $147.00 | — |
| Marin County, CACalifornia | $170.53 | — |
| San Francisco, CACalifornia | $170.45 | — |
| San Benito County, CACalifornia | $174.36 | — |
| Santa Clara County, CACalifornia | $174.04 | — |
| San Luis Obispo, CACalifornia | $140.75 | — |
| Santa Cruz, CACalifornia | $148.80 | — |
| Santa Maria, CACalifornia | $143.80 | — |
| Santa Rosa, CACalifornia | $150.34 | — |
| Stockton, CACalifornia | $136.24 | — |
| Vallejo, CACalifornia | $160.25 | — |
| Visalia, CACalifornia | $136.24 | — |
| Yuba City, CACalifornia | $136.24 | — |
| Washington, DC areaDistrict of Columbia | $146.92 | — |
| Miami, FLFlorida | $134.80 | — |
| Chicago, ILIllinois | $130.61 | — |
| Manhattan, NYNew York | $146.55 | — |
| AlaskaAlaska | $142.54 | — |
| AlabamaAlabama | $112.80 | — |
| ArkansasArkansas | $111.00 | — |
| ArizonaArizona | $123.34 | — |
| ColoradoColorado | $133.36 | — |
| ConnecticutConnecticut | $135.88 | — |
| DelawareDelaware | $125.53 | — |
| Fort Lauderdale, FLFlorida | $130.18 | — |
| Rest of FloridaFlorida | $123.48 | — |
| Atlanta, GAGeorgia | $129.13 | — |
| Rest of GeorgiaGeorgia | $116.05 | — |
| Hawaii, Guam, HIHawaii | $140.31 | — |
| IowaIowa | $116.60 | — |
| IdahoIdaho | $117.30 | — |
| East St. Louis, ILIllinois | $120.90 | — |
| Rest of IllinoisIllinois | $119.12 | — |
| Suburban Chicago, ILIllinois | $131.70 | — |
| IndianaIndiana | $118.07 | — |
| KansasKansas | $115.70 | — |
| KentuckyKentucky | $115.08 | — |
| New Orleans, LALouisiana | $121.05 | — |
| Rest of LouisianaLouisiana | $114.76 | — |
| Metropolitan Boston, MAMassachusetts | $147.82 | — |
| Rest of MassachusettsMassachusetts | $132.32 | — |
| Baltimore area, MDMaryland | $135.45 | — |
| Rest of MarylandMaryland | $128.19 | — |
| Rest of MaineMaine | $117.65 | — |
| Southern Maine, MEMaine | $125.12 | — |
| Detroit, MIMichigan | $124.86 | — |
| Rest of MichiganMichigan | $118.10 | — |
| MinnesotaMinnesota | $128.32 | — |
| Metropolitan Kansas City, MOMissouri | $120.47 | — |
| Metropolitan St. Louis, MOMissouri | $121.89 | — |
| Rest of MissouriMissouri | $112.39 | — |
| MississippiMississippi | $111.74 | — |
| MontanaMontana | $126.92 | — |
| North CarolinaNorth Carolina | $119.05 | — |
| North DakotaNorth Dakota | $125.53 | — |
| NebraskaNebraska | $117.39 | — |
| New HampshireNew Hampshire | $130.93 | — |
| Northern New JerseyNew Jersey | $145.10 | — |
| Rest of New JerseyNew Jersey | $137.59 | — |
| New MexicoNew Mexico | $118.69 | — |
| NevadaNevada | $126.64 | — |
| NYC suburbs and Long Island, NYNew York | $150.01 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $138.26 | — |
| Queens, NYNew York | $148.31 | — |
| Rest of New YorkNew York | $120.99 | — |
| OhioOhio | $117.82 | — |
| OklahomaOklahoma | $115.18 | — |
| Portland, OROregon | $138.28 | — |
| Rest of OregonOregon | $125.81 | — |
| Metropolitan Philadelphia, PAPennsylvania | $132.03 | — |
| Rest of PennsylvaniaPennsylvania | $118.19 | — |
| Puerto RicoPuerto Rico | $128.04 | — |
| Rhode IslandRhode Island | $130.51 | — |
| South CarolinaSouth Carolina | $118.60 | — |
| South DakotaSouth Dakota | $125.37 | — |
| TennesseeTennessee | $116.30 | — |
| Austin, TXTexas | $132.78 | — |
| Beaumont, TXTexas | $117.32 | — |
| Brazoria, TXTexas | $125.62 | — |
| Dallas, TXTexas | $126.35 | — |
| Fort Worth, TXTexas | $125.33 | — |
| Galveston, TXTexas | $125.94 | — |
| Houston, TXTexas | $127.23 | — |
| Rest of TexasTexas | $121.35 | — |
| UtahUtah | $120.39 | — |
| VirginiaVirginia | $124.45 | — |
| Virgin Islands, VIUnited States Virgin Islands | $128.04 | — |
| VermontVermont | $124.72 | — |
| Rest of WashingtonWashington | $132.18 | — |
| King County, WAWashington | $151.29 | — |
| WisconsinWisconsin | $120.90 | — |
| West VirginiaWest Virginia | $114.19 | — |
| WyomingWyoming | $126.32 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $142.54 | 1 |
| AL | $112.80 | 1 |
| AR | $111.00 | 1 |
| AZ | $123.34 | 1 |
| CA | $136.24–$174.36 | 29 |
| CO | $133.36 | 1 |
| CT | $135.88 | 1 |
| DC | $146.92 | 1 |
| DE | $125.53 | 1 |
| FL | $123.48–$134.80 | 3 |
| GA | $116.05–$129.13 | 2 |
| GU | $140.31 | 1 |
| HI | $140.31 | 1 |
| IA | $116.60 | 1 |
| ID | $117.30 | 1 |
| IL | $119.12–$131.70 | 4 |
| IN | $118.07 | 1 |
| KS | $115.70 | 1 |
| KY | $115.08 | 1 |
| LA | $114.76–$121.05 | 2 |
| MA | $132.32–$147.82 | 2 |
| MD | $128.19–$146.92 | 3 |
| ME | $117.65–$125.12 | 2 |
| MI | $118.10–$124.86 | 2 |
| MN | $128.32 | 1 |
| MO | $112.39–$121.89 | 3 |
| MS | $111.74 | 1 |
| MT | $126.92 | 1 |
| NC | $119.05 | 1 |
| ND | $125.53 | 1 |
| NE | $117.39 | 1 |
| NH | $130.93 | 1 |
| NJ | $137.59–$145.10 | 2 |
| NM | $118.69 | 1 |
| NV | $126.64 | 1 |
| NY | $120.99–$150.01 | 5 |
| OH | $117.82 | 1 |
| OK | $115.18 | 1 |
| OR | $125.81–$138.28 | 2 |
| PA | $118.19–$132.03 | 2 |
| PR | $128.04 | 1 |
| RI | $130.51 | 1 |
| SC | $118.60 | 1 |
| SD | $125.37 | 1 |
| TN | $116.30 | 1 |
| TX | $117.32–$132.78 | 8 |
| UT | $120.39 | 1 |
| VA | $124.45–$146.92 | 2 |
| VI | $128.04 | 1 |
| VT | $124.72 | 1 |
| WA | $132.18–$151.29 | 2 |
| WI | $120.90 | 1 |
| WV | $114.19 | 1 |
| WY | $126.32 | 1 |
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
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.
The exact Merced, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,248
- Code
- 78191
- Physician work
- 0.59
- Practice expense
- 3.14
- Malpractice
- 0.07
GPCI2026.csv
15
- Locality
- Merced, CA
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.017 | 0.6000 |
| Practice expense | 3.14 | × 1.096 | 3.4414 |
| Malpractice | 0.07 | × 0.536 | 0.0375 |
| Total RVUs | 4.0790 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Merced, CA$136.24
Office: (0.59 × 1.017 + 3.14 × 1.096 + 0.07 × 0.536) × $33.4009 = $136.24
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 78191 has changed in Merced, CA
78191 · Office / nonfacility
$136.24
Effective 2026-10-01
The base rate is $6.96 higher than on 2025-10-01, moving from $129.28 to $136.24 (5.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$129.28changed to$136.24
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.61 changed to 0.59
- Practice expense RVU 3.06 changed to 3.14
- Malpractice RVU 0.06 changed to 0.07
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$132.50changed to$129.28
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.04 changed to 3.06
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$130.34changed to$132.50
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$132.54changed to$130.34
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.01 changed to 3.04
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.579 changed to 0.560
January 1, 2023
RVU23A
$134.96changed to$132.54
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.04 changed to 3.01
- Malpractice RVU 0.06 changed to 0.07
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.597 changed to 0.579
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$135.71changed to$134.96
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.03 changed to 3.04
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$136.56changed to$135.71
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.92 changed to 3.03
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.580 changed to 0.597
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$135.68changed to$136.56
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.90 changed to 2.92
- Malpractice RVU 0.05 changed to 0.06
- Work GPCI 1.020 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.562 changed to 0.580
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$151.77changed to$135.68
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.32 changed to 2.90
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$187.15changed to$151.77
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.22 changed to 3.32
- Malpractice RVU 0.06 changed to 0.05
- Work GPCI 1.024 changed to 1.020
- Practice expense GPCI 1.079 changed to 1.074
- Malpractice GPCI 0.610 changed to 0.562
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$187.15
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $136.24 | Not available in this setting | RVU26D |
| 2026-07-01 | $136.24 | Not available in this setting | RVU26C |
| 2026-04-01 | $136.24 | Not available in this setting | RVU26B |
| 2026-01-01 | $136.24 | Not available in this setting | RVU26A |
| 2025-10-01 | $129.28 | Not available in this setting | RVU25D |
| 2025-07-01 | $129.28 | Not available in this setting | RVU25C |
| 2025-04-01 | $129.28 | Not available in this setting | RVU25B |
| 2025-01-01 | $129.28 | Not available in this setting | RVU25A |
| 2024-10-01 | $132.50 | Not available in this setting | RVU24D |
| 2024-07-01 | $132.50 | Not available in this setting | RVU24C |
| 2024-04-01 | $132.50 | Not available in this setting | RVU24B |
| 2024-03-09 | $132.50 | Not available in this setting | RVU24AR |
| 2024-01-01 | $130.34 | Not available in this setting | RVU24A |
| 2023-10-01 | $132.54 | Not available in this setting | RVU23D |
| 2023-07-01 | $132.54 | Not available in this setting | RVU23C |
| 2023-04-01 | $132.54 | Not available in this setting | RVU23B |
| 2023-01-01 | $132.54 | Not available in this setting | RVU23A |
| 2022-10-01 | $134.96 | Not available in this setting | RVU22D |
| 2022-07-01 | $134.96 | Not available in this setting | RVU22C |
| 2022-04-01 | $134.96 | Not available in this setting | RVU22B |
| 2022-01-01 | $134.96 | Not available in this setting | RVU22A |
| 2021-10-01 | $135.71 | Not available in this setting | RVU21D |
| 2021-07-01 | $135.71 | Not available in this setting | RVU21C |
| 2021-04-01 | $135.71 | Not available in this setting | RVU21B |
| 2021-01-01 | $135.71 | Not available in this setting | RVU21A |
| 2020-10-01 | $136.56 | Not available in this setting | RVU20D |
| 2020-07-01 | $136.56 | Not available in this setting | RVU20C |
| 2020-04-01 | $136.56 | Not available in this setting | RVU20B |
| 2020-01-01 | $136.56 | Not available in this setting | RVU20A |
| 2019-10-01 | $135.68 | Not available in this setting | RVU19D |
| 2019-07-01 | $135.68 | Not available in this setting | RVU19C |
| 2019-04-01 | $135.68 | Not available in this setting | RVU19B |
| 2019-01-01 | $135.68 | Not available in this setting | RVU19A |
| 2018-10-01 | $151.77 | Not available in this setting | RVU18D |
| 2018-07-01 | $151.77 | Not available in this setting | RVU18C |
| 2018-04-01 | $151.77 | Not available in this setting | RVU18B |
| 2018-01-01 | $151.77 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $187.15 | Not available in this setting | RVU17D |
| 2017-07-01 | $187.15 | Not available in this setting | RVU17C |
| 2017-04-01 | $187.15 | Not available in this setting | RVU17B |
| 2017-01-01 | $187.15 | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Merced, CA rate applies
Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
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
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