CPT code 78202: Liver imaging, with vascular-flow phase2026 Medicare rate & RVUs in Virginia
Reports radionuclide liver imaging that includes vascular-flow acquisition, used when the diagnostic study evaluates hepatic perfusion along with liver distribution.
In Virginia, Medicare pays $188.43 for 78202 in the office.
Check a contract rate as a % of Medicare · 78202 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 78202 covers
This nuclear medicine study images the liver and includes acquisition of a vascular-flow phase. A nuclear medicine technologist performs the imaging in a hospital or other diagnostic imaging department, and a qualified practitioner interprets the study. The flow images add information about hepatic perfusion to the images showing distribution in the liver; the order and report should identify the clinical question and the imaging performed.
Select this code when the study covers the liver and includes vascular-flow imaging. Use the static-only liver code when flow imaging is not performed, and distinguish liver-only imaging from studies that also include the spleen. The record should support the liver study, the flow acquisition, and the interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Both modifiers are separately priced.
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 Virginia compares for 78202
Across 109 of 109 payment localities, the office rate for 78202 runs from $166.53 in Arkansas to $269.28 in San Benito County, CA. Virginia pays $188.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$188.43
- Los Angeles, CA · California$223.62+$35.19
- Washington, DC area · District of Columbia$224.02+$35.59
- Miami, FL · Florida$202.72+$14.29
- Chicago, IL · Illinois$196.06+$7.63
- Manhattan, NY · New York$222.52+$34.09
- Alaska · Alaska$210.60+$22.17
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $169.41 | — |
| ArkansasArkansas | $166.53 | — |
| ArizonaArizona | $186.35 | — |
| Bakersfield, CACalifornia | $208.07 | — |
| Chico, CACalifornia | $207.86 | — |
| El Centro, CACalifornia | $207.88 | — |
| Fresno, CACalifornia | $207.86 | — |
| Hanford, CACalifornia | $207.86 | — |
| Madera, CACalifornia | $207.86 | — |
| Merced, CACalifornia | $207.86 | — |
| Modesto, CACalifornia | $207.86 | — |
| Napa, CACalifornia | $246.98 | — |
| Oxnard, CACalifornia | $223.13 | — |
| Redding, CACalifornia | $207.86 | — |
| Rest of CaliforniaCalifornia | $207.86 | — |
| Riverside, CACalifornia | $208.62 | — |
| Sacramento, CACalifornia | $219.77 | — |
| Salinas, CACalifornia | $219.00 | — |
| San Diego, CACalifornia | $225.40 | — |
| Marin County, CACalifornia | $263.31 | — |
| San Francisco, CACalifornia | $263.23 | — |
| San Benito County, CACalifornia | $269.28 | — |
| Santa Clara County, CACalifornia | $268.96 | — |
| San Luis Obispo, CACalifornia | $215.30 | — |
| Santa Cruz, CACalifornia | $228.52 | — |
| Santa Maria, CACalifornia | $220.16 | — |
| Santa Rosa, CACalifornia | $230.92 | — |
| Stockton, CACalifornia | $207.86 | — |
| Vallejo, CACalifornia | $246.86 | — |
| Visalia, CACalifornia | $207.86 | — |
| Yuba City, CACalifornia | $207.86 | — |
| ColoradoColorado | $202.82 | — |
| ConnecticutConnecticut | $206.20 | — |
| DelawareDelaware | $189.83 | — |
| Fort Lauderdale, FLFlorida | $196.19 | — |
| Rest of FloridaFlorida | $185.62 | — |
| Atlanta, GAGeorgia | $195.34 | — |
| Rest of GeorgiaGeorgia | $173.82 | — |
| Hawaii, Guam, HIHawaii | $214.77 | — |
| IowaIowa | $175.94 | — |
| IdahoIdaho | $176.98 | — |
| East St. Louis, ILIllinois | $180.58 | — |
| Rest of IllinoisIllinois | $178.32 | — |
| Suburban Chicago, ILIllinois | $198.65 | — |
| IndianaIndiana | $178.22 | — |
| KansasKansas | $174.29 | — |
| KentuckyKentucky | $172.65 | — |
| New Orleans, LALouisiana | $182.17 | — |
| Rest of LouisianaLouisiana | $172.06 | — |
| Metropolitan Boston, MAMassachusetts | $226.05 | — |
| Rest of MassachusettsMassachusetts | $201.02 | — |
| Baltimore area, MDMaryland | $205.51 | — |
| Rest of MarylandMaryland | $194.11 | — |
| Rest of MaineMaine | $177.33 | — |
| Southern Maine, MEMaine | $189.64 | — |
| Detroit, MIMichigan | $187.60 | — |
| Rest of MichiganMichigan | $177.30 | — |
| MinnesotaMinnesota | $195.43 | — |
| Metropolitan Kansas City, MOMissouri | $181.45 | — |
| Metropolitan St. Louis, MOMissouri | $183.76 | — |
| Rest of MissouriMissouri | $168.12 | — |
| MississippiMississippi | $167.40 | — |
| MontanaMontana | $192.05 | — |
| North CarolinaNorth Carolina | $179.62 | — |
| North DakotaNorth Dakota | $190.67 | — |
| NebraskaNebraska | $177.28 | — |
| New HampshireNew Hampshire | $198.86 | — |
| Northern New JerseyNew Jersey | $220.95 | — |
| Rest of New JerseyNew Jersey | $208.87 | — |
| New MexicoNew Mexico | $178.16 | — |
| NevadaNevada | $191.84 | — |
| NYC suburbs and Long Island, NYNew York | $227.83 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $209.73 | — |
| Queens, NYNew York | $225.65 | — |
| Rest of New YorkNew York | $182.71 | — |
| OhioOhio | $177.02 | — |
| OklahomaOklahoma | $173.02 | — |
| Portland, OROregon | $210.93 | — |
| Rest of OregonOregon | $190.67 | — |
| Metropolitan Philadelphia, PAPennsylvania | $199.90 | — |
| Rest of PennsylvaniaPennsylvania | $177.74 | — |
| Puerto RicoPuerto Rico | $193.92 | — |
| Rhode IslandRhode Island | $197.83 | — |
| South CarolinaSouth Carolina | $178.56 | — |
| South DakotaSouth Dakota | $190.50 | — |
| TennesseeTennessee | $175.23 | — |
| Austin, TXTexas | $201.86 | — |
| Beaumont, TXTexas | $176.32 | — |
| Brazoria, TXTexas | $190.12 | — |
| Dallas, TXTexas | $191.18 | — |
| Fort Worth, TXTexas | $189.48 | — |
| Galveston, TXTexas | $190.58 | — |
| Houston, TXTexas | $191.86 | — |
| Rest of TexasTexas | $183.00 | — |
| UtahUtah | $181.44 | — |
| Virgin Islands, VIUnited States Virgin Islands | $193.92 | — |
| VermontVermont | $189.17 | — |
| Rest of WashingtonWashington | $200.88 | — |
| King County, WAWashington | $231.74 | — |
| WisconsinWisconsin | $183.17 | — |
| West VirginiaWest Virginia | $170.40 | — |
| WyomingWyoming | $191.45 | — |
78202 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.
$166.53
$238.57
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 | $210.60 | 1 |
| AL | $169.41 | 1 |
| AR | $166.53 | 1 |
| AZ | $186.35 | 1 |
| CA | $207.86–$269.28 | 29 |
| CO | $202.82 | 1 |
| CT | $206.20 | 1 |
| DC | $224.02 | 1 |
| DE | $189.83 | 1 |
| FL | $185.62–$202.72 | 3 |
| GA | $173.82–$195.34 | 2 |
| GU | $214.77 | 1 |
| HI | $214.77 | 1 |
| IA | $175.94 | 1 |
| ID | $176.98 | 1 |
| IL | $178.32–$198.65 | 4 |
| IN | $178.22 | 1 |
| KS | $174.29 | 1 |
| KY | $172.65 | 1 |
| LA | $172.06–$182.17 | 2 |
| MA | $201.02–$226.05 | 2 |
| MD | $194.11–$224.02 | 3 |
| ME | $177.33–$189.64 | 2 |
| MI | $177.30–$187.60 | 2 |
| MN | $195.43 | 1 |
| MO | $168.12–$183.76 | 3 |
| MS | $167.40 | 1 |
| MT | $192.05 | 1 |
| NC | $179.62 | 1 |
| ND | $190.67 | 1 |
| NE | $177.28 | 1 |
| NH | $198.86 | 1 |
| NJ | $208.87–$220.95 | 2 |
| NM | $178.16 | 1 |
| NV | $191.84 | 1 |
| NY | $182.71–$227.83 | 5 |
| OH | $177.02 | 1 |
| OK | $173.02 | 1 |
| OR | $190.67–$210.93 | 2 |
| PA | $177.74–$199.90 | 2 |
| PR | $193.92 | 1 |
| RI | $197.83 | 1 |
| SC | $178.56 | 1 |
| SD | $190.50 | 1 |
| TN | $175.23 | 1 |
| TX | $176.32–$201.86 | 8 |
| UT | $181.44 | 1 |
| VA | $188.43–$224.02 | 2 |
| VI | $193.92 | 1 |
| VT | $189.17 | 1 |
| WA | $200.88–$231.74 | 2 |
| WI | $183.17 | 1 |
| WV | $170.40 | 1 |
| WY | $191.45 | 1 |
How the 78202 rate is calculated
Each of 78202’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 · 78202
RVUs × geographic indexes × conversion factor
Work0.50
0.50 RVUs× 1.000 GPCI
Practice expense5.18
5.18 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
5.7500
Conversion factor
$33.4009
Medicare rate
$192.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,260
- Code
- 78202
- Physician work
- 0.50
- Practice expense
- 5.18
- Malpractice
- 0.07
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 5.18 | × 0.983 | 5.0919 |
| Malpractice | 0.07 | × 0.706 | 0.0494 |
| Total RVUs | 5.6414 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$188.43
Office: (0.5 × 1 + 5.18 × 0.983 + 0.07 × 0.706) × $33.4009 = $188.43
Payment rules and modifiers for 78202
The CMS indicators that decide how 78202 is paid alongside other services.
CMS payment indicators · 78202
Liver imaging, with vascular-flow phase
| 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
78202 without 26 · national office
$192.06
Liver imaging, with vascular-flow phase
78202-26 · Professional component
$23.05
Pays only the interpretation and report.
How 78202 has changed in Virginia
78202 · Office / nonfacility
$188.43
Effective 2026-10-01
The base rate is $3.09 higher than on 2025-10-01, moving from $185.34 to $188.43 (1.7%).
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
$185.34changed to$188.43
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.51 changed to 0.50
- Practice expense RVU 5.25 changed to 5.18
- Work GPCI 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$190.81changed to$185.34
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.26 changed to 5.25
- Malpractice RVU 0.06 changed to 0.07
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$187.69changed to$190.81
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$196.10changed to$187.69
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.28 changed to 5.26
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$206.14changed to$196.10
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.42 changed to 5.28
- Practice expense GPCI 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$213.75changed to$206.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.59 changed to 5.42
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$210.24changed to$213.75
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 5.30 changed to 5.59
- Malpractice RVU 0.07 changed to 0.06
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$206.93changed to$210.24
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 5.26 changed to 5.30
- Malpractice RVU 0.05 changed to 0.07
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$207.77changed to$206.93
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 5.29 changed to 5.26
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$206.86changed to$207.77
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$206.98changed to$206.86
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 5.32 changed to 5.29
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$205.66changed to$206.98
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 5.27 changed to 5.32
- Malpractice RVU 0.04 changed to 0.05
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$204.64changed to$205.66
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$202.99changed to$204.64
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.23 changed to 5.27
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$205.82changed to$202.99
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 5.64 changed to 5.23
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $205.82
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $188.43 | Not available in this setting | RVU26D |
| 2026-07-01 | $188.43 | Not available in this setting | RVU26C |
| 2026-04-01 | $188.43 | Not available in this setting | RVU26B |
| 2026-01-01 | $188.43 | Not available in this setting | RVU26A |
| 2025-10-01 | $185.34 | Not available in this setting | RVU25D |
| 2025-07-01 | $185.34 | Not available in this setting | RVU25C |
| 2025-04-01 | $185.34 | Not available in this setting | RVU25B |
| 2025-01-01 | $185.34 | Not available in this setting | RVU25A |
| 2024-10-01 | $190.81 | Not available in this setting | RVU24D |
| 2024-07-01 | $190.81 | Not available in this setting | RVU24C |
| 2024-04-01 | $190.81 | Not available in this setting | RVU24B |
| 2024-03-09 | $190.81 | Not available in this setting | RVU24AR |
| 2024-01-01 | $187.69 | Not available in this setting | RVU24A |
| 2023-10-01 | $196.10 | Not available in this setting | RVU23D |
| 2023-07-01 | $196.10 | Not available in this setting | RVU23C |
| 2023-04-01 | $196.10 | Not available in this setting | RVU23B |
| 2023-01-01 | $196.10 | Not available in this setting | RVU23A |
| 2022-10-01 | $206.14 | Not available in this setting | RVU22D |
| 2022-07-01 | $206.14 | Not available in this setting | RVU22C |
| 2022-04-01 | $206.14 | Not available in this setting | RVU22B |
| 2022-01-01 | $206.14 | Not available in this setting | RVU22A |
| 2021-10-01 | $213.75 | Not available in this setting | RVU21D |
| 2021-07-01 | $213.75 | Not available in this setting | RVU21C |
| 2021-04-01 | $213.75 | Not available in this setting | RVU21B |
| 2021-01-01 | $213.75 | Not available in this setting | RVU21A |
| 2020-10-01 | $210.24 | Not available in this setting | RVU20D |
| 2020-07-01 | $210.24 | Not available in this setting | RVU20C |
| 2020-04-01 | $210.24 | Not available in this setting | RVU20B |
| 2020-01-01 | $210.24 | Not available in this setting | RVU20A |
| 2019-10-01 | $206.93 | Not available in this setting | RVU19D |
| 2019-07-01 | $206.93 | Not available in this setting | RVU19C |
| 2019-04-01 | $206.93 | Not available in this setting | RVU19B |
| 2019-01-01 | $206.93 | Not available in this setting | RVU19A |
| 2018-10-01 | $207.77 | Not available in this setting | RVU18D |
| 2018-07-01 | $207.77 | Not available in this setting | RVU18C |
| 2018-04-01 | $207.77 | Not available in this setting | RVU18B |
| 2018-01-01 | $207.77 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $206.86 | Not available in this setting | RVU17D |
| 2017-07-01 | $206.86 | Not available in this setting | RVU17C |
| 2017-04-01 | $206.86 | Not available in this setting | RVU17B |
| 2017-01-01 | $206.86 | Not available in this setting | RVU17A |
| 2016-10-01 | $206.98 | Not available in this setting | RVU16D |
| 2016-07-01 | $206.98 | Not available in this setting | RVU16C |
| 2016-04-01 | $206.98 | Not available in this setting | RVU16B |
| 2016-01-01 | $206.98 | Not available in this setting | RVU16A |
| 2015-10-01 | $205.66 | Not available in this setting | RVU15D |
| 2015-07-01 | $205.66 | Not available in this setting | RVU15C |
| 2015-04-01 | $204.64 | Not available in this setting | RVU15B |
| 2015-01-01 | $204.64 | Not available in this setting | RVU15A |
| 2014-10-01 | $202.99 | Not available in this setting | RVU14D |
| 2014-07-01 | $202.99 | Not available in this setting | RVU14C |
| 2014-04-01 | $202.99 | Not available in this setting | RVU14B |
| 2014-01-01 | $202.99 | Not available in this setting | RVU14A |
| 2013-10-01 | $205.82 | Not available in this setting | RVU13D |
| 2013-07-01 | $205.82 | Not available in this setting | RVU13C |
| 2013-04-01 | $205.82 | Not available in this setting | RVU13B |
| 2013-01-01 | $205.82 | Not available in this setting | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
78202 billing questions
How does this differ from 78201?
78202 includes a vascular-flow phase with liver imaging. 78201 is for liver imaging without that flow phase.
When should 78216 be used instead?
78216 includes both liver and spleen imaging with vascular flow. Use 78202 when the performed study images the liver only.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.
What should the report document?
Document the liver imaging and vascular-flow acquisition, the clinical indication, and the interpreting practitioner's findings. The record should make clear whether the spleen was also imaged.
Is each image or flow acquisition billed as a separate unit?
The code represents the liver imaging study with vascular flow, not each individual image. Report the study performed rather than counting its image frames as separate services.
Is this the same as hepatobiliary imaging?
No. 78202 evaluates liver distribution with vascular-flow imaging; 78226 concerns hepatobiliary system imaging and addresses a different imaging question.
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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