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

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

CMS RVU26DEffective Oct 1, 2026One payment locality

In New Hampshire, Medicare pays $130.93 for 78191 in the office.

$130.93Office (non-facility)
Not available in this settingHospital or facility
+3.2%vs the national office rate ($126.92)

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.

We’ll open 78191 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Hampshire
  2. What 78191 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 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 New Hampshire 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. New Hampshire pays $130.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

78191 in New Hampshire vs other payment areas
  1. New Hampshire · this page$130.93
  2. Los Angeles, CA · California$146.14+$15.21
  3. Washington, DC area · District of Columbia$146.92+$15.99
  4. Miami, FL · Florida$134.80+$3.87
  5. Chicago, IL · Illinois$130.61−$0.32
  6. Manhattan, NY · New York$146.55+$15.62
  7. Alaska · Alaska$142.54+$11.61

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

Every other payment area

78191 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$112.80—
ArkansasArkansas$111.00—
ArizonaArizona$123.34—
Bakersfield, CACalifornia$136.45—
Chico, CACalifornia$136.24—
El Centro, CACalifornia$136.25—
Fresno, CACalifornia$136.24—
Hanford, CACalifornia$136.24—

78191 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.

$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

See 78191 in every payment locality

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.

The exact New Hampshire 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

74

Locality
New Hampshire
Physician work
1.000
Practice expense
1.041
Malpractice
0.875
Office calculation for 78191 in New Hampshire
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense3.14× 1.0413.2687
Malpractice0.07× 0.8750.0613
Total RVUs3.9200
Conversion factor× 33.4009

Office rate, New Hampshire$130.93

Office: (0.59 × 1 + 3.14 × 1.041 + 0.07 × 0.875) × $33.4009 = $130.93

Open 78191 in the RVU calculator

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

Codes related to 78191

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

Codes related to 78191
CodeHow it relatesOffice range, New Hampshire
Used instead
78130Red-cell survival, erythrocyte lifespanTracks red-cell rather than platelet survival when the diagnostic question concerns red-cell lifespan.$130.93
78140Red-cell study, splenic sequestrationEvaluates red-cell sequestration rather than platelet survival.$113.31
78185Spleen imaging, radionuclide studyImaging of the spleen, rather than a study measuring platelet survival.$159.83

How 78191 has changed in New Hampshire

78191 · Office / nonfacility

$130.93

Effective 2026-10-01

The base rate is $7.11 higher than on 2025-10-01, moving from $123.82 to $130.93 (5.7%).

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

    $123.82changed to$130.93

    • 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
    • Practice expense GPCI 1.034 changed to 1.041
    • Malpractice GPCI 0.898 changed to 0.875

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $127.03changed to$123.82

    • 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.

  3. March 9, 2024

    RVU24AR

    $124.96changed to$127.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $128.50changed to$124.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.01 changed to 3.04
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 0.907 changed to 0.898

  5. January 1, 2023

    RVU23A

    $132.21changed to$128.50

    • 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
    • Practice expense GPCI 1.038 changed to 1.036
    • Malpractice GPCI 0.917 changed to 0.907

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $132.95changed to$132.21

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.03 changed to 3.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $133.95changed to$132.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.92 changed to 3.03
    • Practice expense GPCI 1.042 changed to 1.038
    • Malpractice GPCI 0.984 changed to 0.917

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $133.09changed to$133.95

    • 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
    • Practice expense GPCI 1.045 changed to 1.042
    • Malpractice GPCI 1.050 changed to 0.984

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $148.75changed to$133.09

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.32 changed to 2.90

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $183.29changed to$148.75

    • 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
    • Practice expense GPCI 1.052 changed to 1.045
    • Malpractice GPCI 0.962 changed to 1.050

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $183.57changed to$183.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.058 changed to 1.052
    • Malpractice GPCI 0.873 changed to 0.962

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $181.82changed to$183.57

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.14 changed to 4.22
    • Malpractice RVU 0.08 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $180.92changed to$181.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $180.96changed to$180.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.16 changed to 4.14
    • Practice expense GPCI 1.051 changed to 1.058
    • Malpractice GPCI 0.867 changed to 0.873

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$180.96

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$130.93Not available in this settingRVU26D
2026-07-01$130.93Not available in this settingRVU26C
2026-04-01$130.93Not available in this settingRVU26B
2026-01-01$130.93Not available in this settingRVU26A
2025-10-01$123.82Not available in this settingRVU25D
2025-07-01$123.82Not available in this settingRVU25C
2025-04-01$123.82Not available in this settingRVU25B
2025-01-01$123.82Not available in this settingRVU25A
2024-10-01$127.03Not available in this settingRVU24D
2024-07-01$127.03Not available in this settingRVU24C
2024-04-01$127.03Not available in this settingRVU24B
2024-03-09$127.03Not available in this settingRVU24AR
2024-01-01$124.96Not available in this settingRVU24A
2023-10-01$128.50Not available in this settingRVU23D
2023-07-01$128.50Not available in this settingRVU23C
2023-04-01$128.50Not available in this settingRVU23B
2023-01-01$128.50Not available in this settingRVU23A
2022-10-01$132.21Not available in this settingRVU22D
2022-07-01$132.21Not available in this settingRVU22C
2022-04-01$132.21Not available in this settingRVU22B
2022-01-01$132.21Not available in this settingRVU22A
2021-10-01$132.95Not available in this settingRVU21D
2021-07-01$132.95Not available in this settingRVU21C
2021-04-01$132.95Not available in this settingRVU21B
2021-01-01$132.95Not available in this settingRVU21A
2020-10-01$133.95Not available in this settingRVU20D
2020-07-01$133.95Not available in this settingRVU20C
2020-04-01$133.95Not available in this settingRVU20B
2020-01-01$133.95Not available in this settingRVU20A
2019-10-01$133.09Not available in this settingRVU19D
2019-07-01$133.09Not available in this settingRVU19C
2019-04-01$133.09Not available in this settingRVU19B
2019-01-01$133.09Not available in this settingRVU19A
2018-10-01$148.75Not available in this settingRVU18D
2018-07-01$148.75Not available in this settingRVU18C
2018-04-01$148.75Not available in this settingRVU18B
2018-01-01$148.75Not available in this settingRVU18AR1
2017-10-01$183.29Not available in this settingRVU17D
2017-07-01$183.29Not available in this settingRVU17C
2017-04-01$183.29Not available in this settingRVU17B
2017-01-01$183.29Not available in this settingRVU17A
2016-10-01$183.57Not available in this settingRVU16D
2016-07-01$183.57Not available in this settingRVU16C
2016-04-01$183.57Not available in this settingRVU16B
2016-01-01$183.57Not available in this settingRVU16A
2015-10-01$181.82Not available in this settingRVU15D
2015-07-01$181.82Not available in this settingRVU15C
2015-04-01$180.92Not available in this settingRVU15B
2015-01-01$180.92Not available in this settingRVU15A
2014-10-01$180.96Not available in this settingRVU14D
2014-07-01$180.96Not available in this settingRVU14C
2014-04-01$180.96Not available in this settingRVU14B
2014-01-01$180.96Not available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 78191 for an earlier date of service

Where the New Hampshire rate applies

New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New Hampshire

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)
Geographic factors for New HampshireGPCI2026.csv, line 74 (RVU26D)

Open CMS sourceHow we calculate rates

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