CPT code 78216: Liver-spleen scan, with vascular flow2026 Medicare rate & RVUs

Medicare pays $131.93 for 78216 nationally in the office. Local office rates run $115.16–$181.92.

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

What 78216 covers

This nuclear medicine examination records vascular flow to the liver and spleen, then obtains images showing radiopharmaceutical distribution in both organs. A gamma camera captures the study after tracer administration. It is typically performed in a hospital nuclear medicine department when the clinical question calls for perfusion information together with liver-and-spleen imaging; a nuclear medicine physician or radiologist interprets the images.

Select 78216 when the performed study images both liver and spleen and includes vascular-flow imaging. A liver-only flow examination or a static liver-spleen examination has a different code. The report and technical record should support the organs imaged, flow acquisition, tracer administration, and interpretation. CMS recognizes professional and technical components: bill modifier 26 for the physician’s interpretation, modifier TC for equipment and staff, or no component modifier for the global service. CMS separately prices modifiers 26 and TC.

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 78216 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

78216 rates by state

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

How the 78216 rate is calculated

Each of 78216’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 78216

The CMS indicators that decide how 78216 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78216 compared with similar codes

How to choose

78215Liver-spleen scanStatic images only

Choose 78215 for liver-and-spleen imaging without vascular-flow acquisition; 78216 includes flow imaging.

78202Liver imagingWith vascular-flow phase

78202 covers liver imaging with vascular flow. 78216 is for a study that images both the liver and spleen with flow.

78226Hepatobiliary imagingWithout drug intervention

78226 is hepatobiliary system imaging, rather than the liver-and-spleen examination with vascular-flow acquisition represented by 78216.

Codes related to 78216

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

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