CPT code 78195: Lymphatic imaging, lymphoscintigraphy2026 Medicare rate & RVUs in Florida
Lymphoscintigraphy tracks radiotracer through lymphatic channels and nodes to evaluate lymphatic drainage, including lymphedema or sentinel-node mapping.
Medicare pays $301.65–$328.27 for 78195 in the office in Florida, from Rest of Florida to Miami, FL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 78195 covers
This nuclear medicine study uses a radiotracer and gamma-camera images to show lymphatic drainage and regional nodes. It may help evaluate impaired drainage in a patient with suspected lymphedema or map sentinel nodes before cancer surgery, such as for breast cancer or melanoma. A nuclear medicine physician or radiologist typically interprets the images; imaging is performed in a nuclear medicine department or other equipped facility.
Report 78195 for imaging of the lymphatic system, rather than a study focused on the spleen or bone marrow. Documentation should identify the clinical indication, tracer and injection site when known, images obtained, and interpretation of lymphatic flow or nodal drainage. For sentinel-node work, 38792 may represent the tracer injection when that service is performed and documented. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither for the global service.
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 78195 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$301.65 to $328.27
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | $318.09 | Unavailable |
| Miami, FL | $328.27 | Unavailable |
| Rest of Florida | $301.65 | Unavailable |
How the 78195 rate is calculated
Each of 78195’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 · 78195
RVUs × geographic indexes × conversion factor
Work1.17
1.17 RVUs× 1.000 GPCI
Practice expense8.05
8.05 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
9.3300
Conversion factor
$33.4009
Medicare rate
$311.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78195
The CMS indicators that decide how 78195 is paid alongside other services.
CMS payment indicators · 78195
Lymphatic imaging, lymphoscintigraphy
| 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
78195 without 26 · national office
$311.63
Lymphatic imaging, lymphoscintigraphy
78195-26 · Professional component
$53.44
Pays only the interpretation and report.
78195 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 38792Sentinel node injectionRadioactive tracer
- This represents the radioactive tracer injection used for sentinel-node identification; 78195 represents the subsequent lymphatic imaging.
- 78185Spleen imagingRadionuclide study
- 78185 evaluates the spleen. Choose 78195 when the study images lymphatic channels or nodal drainage.
- 78199Unlisted procedureHematopoietic/lymphatic system
- 78199 is an unlisted code for a hematopoietic, reticuloendothelial, or lymphatic procedure without a specific code; use 78195 when the service is lymphoscintigraphy.
78195 billing questions
When is 78195 used for sentinel-node mapping?
Use it for the imaging that follows radiotracer administration to visualize lymphatic drainage and sentinel nodes. The injection procedure may be reported separately with 38792 when performed and documented.
Which modifier identifies the interpretation?
Append modifier 26 for the professional interpretation. Modifier TC identifies the technical service, including equipment and staff; no modifier represents the global service.
Does 78195 describe the tracer injection?
It describes lymphatic imaging. A separately performed radioactive tracer injection for sentinel-node identification may be represented by 38792.
How does 78195 differ from spleen imaging 78185?
78195 follows lymphatic drainage and nodes. 78185 is a spleen imaging study, not a substitute for lymphoscintigraphy.
What documentation supports 78195?
Record the indication, tracer and injection details available, imaging performed, and the interpreting clinician’s findings on lymphatic flow or nodal drainage.
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
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