CPT code 78199: Unlisted procedure, hematopoietic/lymphatic system2026 Medicare rate & RVUs in Colorado

CMS doesn’t publish a rate for 78199 in Colorado.

Check a contract rate as a % of Medicare · 78199 nationwide

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

What 78199 covers

78199 identifies an unlisted diagnostic procedure involving the hematopoietic, reticuloendothelial, or lymphatic system. It is selected when no more specific listed procedure code describes the service. Nearby listed nuclear medicine services identify particular studies, including lymphatic imaging, spleen imaging, platelet survival, red-cell survival, and red-cell sequestration; use those codes when their defined study is performed.

For Medicare, 78199 has physician fee schedule status C (carrier priced): CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The diagnostic test has professional and technical components. Modifier 26 identifies professional interpretation; modifier TC identifies the technical service involving equipment and staff. Reporting 78199 without either modifier represents 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.

How Colorado compares for 78199

Every other payment area

78199 rates by state

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

See 78199 in every payment locality

How the 78199 rate is calculated

Each of 78199’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.

Payment rules and modifiers for 78199

The CMS indicators that decide how 78199 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

Codes related to 78199

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

How 78199 has changed in Colorado

Price 78199 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

• Acres Green
• Aetna Estates
• Aguilar
• Air Force Academy
• Akron
• Alamosa
• Alamosa East
• Allenspark

Browse all communities in Colorado

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

Open CMS sourceHow we calculate rates