CPT code 78216: Liver-spleen scan, with vascular flow2026 Medicare rate & RVUs in Missouri
Nuclear medicine imaging of liver and spleen with vascular-flow acquisition, reported when a study evaluates perfusion along with radiopharmaceutical distribution in both organs.
Medicare pays $116.57–$126.62 for 78216 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$116.57 to $126.62
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $125.12 | Unavailable |
| Metropolitan St. Louis, MO | $126.62 | Unavailable |
| Rest of Missouri | $116.57 | Unavailable |
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.
How the rate is built · 78216
RVUs × geographic indexes × conversion factor
Work0.56
0.56 RVUs× 1.000 GPCI
Practice expense3.32
3.32 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
3.9500
Conversion factor
$33.4009
Medicare rate
$131.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78216
The CMS indicators that decide how 78216 is paid alongside other services.
CMS payment indicators · 78216
Liver-spleen scan, with vascular flow
| 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
78216 without 26 · national office
$131.93
Liver-spleen scan, with vascular flow
78216-26 · Professional component
$26.39
Pays only the interpretation and report.
78216 compared with similar codes
Compare codes · National
4 codes, side by side
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.
78216 billing questions
How does 78216 differ from 78215?
78216 includes vascular-flow imaging of the liver and spleen. 78215 describes liver-and-spleen imaging without that flow component.
When would 78202 be more appropriate?
Use 78202 when the vascular-flow examination images the liver without imaging the spleen. Choose 78216 when both organs are imaged with flow.
Can the interpretation and equipment portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical service. Without either modifier, the claim represents the global service.
Are the flow images separately reported from the liver-spleen images?
The vascular-flow acquisition and organ images are elements of this liver-spleen study. The code selection should reflect the complete examination performed.
What documentation supports 78216?
Document that both the liver and spleen were imaged, that vascular-flow images were obtained, and the interpreting physician’s findings.
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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