CPT code 78216: Liver-spleen scan, with vascular flow2026 Medicare rate & RVUs in Montana
Nuclear medicine imaging of liver and spleen with vascular-flow acquisition, reported when a study evaluates perfusion along with radiopharmaceutical distribution in both organs.
In Montana, Medicare pays $131.93 for 78216 in the office.
Check a contract rate as a % of Medicare · 78216 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 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.
How Montana compares for 78216
Across 109 of 109 payment localities, the office rate for 78216 runs from $115.16 in Arkansas to $181.92 in San Benito County, CA. Montana pays $131.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$131.93
- Los Angeles, CA · California$152.21+$20.28
- Washington, DC area · District of Columbia$152.95+$21.02
- Miami, FL · Florida$140.05+$8.12
- Chicago, IL · Illinois$135.65+$3.72
- Manhattan, NY · New York$152.47+$20.54
- Alaska · Alaska$147.44+$15.51
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $117.06 | — |
| ArkansasArkansas | $115.16 | — |
| ArizonaArizona | $128.16 | — |
| Bakersfield, CACalifornia | $142.02 | — |
| Chico, CACalifornia | $141.81 | — |
| El Centro, CACalifornia | $141.82 | — |
| Fresno, CACalifornia | $141.81 | — |
| Hanford, CACalifornia | $141.81 | — |
| Madera, CACalifornia | $141.81 | — |
| Merced, CACalifornia | $141.81 | — |
| Modesto, CACalifornia | $141.81 | — |
| Napa, CACalifornia | $167.22 | — |
| Oxnard, CACalifornia | $151.76 | — |
| Redding, CACalifornia | $141.81 | — |
| Rest of CaliforniaCalifornia | $141.81 | — |
| Riverside, CACalifornia | $142.57 | — |
| Sacramento, CACalifornia | $149.60 | — |
| Salinas, CACalifornia | $149.06 | — |
| San Diego, CACalifornia | $153.16 | — |
| Marin County, CACalifornia | $177.91 | — |
| San Francisco, CACalifornia | $177.83 | — |
| San Benito County, CACalifornia | $181.92 | — |
| Santa Clara County, CACalifornia | $181.60 | — |
| San Luis Obispo, CACalifornia | $146.58 | — |
| Santa Cruz, CACalifornia | $155.08 | — |
| Santa Maria, CACalifornia | $149.78 | — |
| Santa Rosa, CACalifornia | $156.69 | — |
| Stockton, CACalifornia | $141.81 | — |
| Vallejo, CACalifornia | $167.11 | — |
| Visalia, CACalifornia | $141.81 | — |
| Yuba City, CACalifornia | $141.81 | — |
| ColoradoColorado | $138.74 | — |
| ConnecticutConnecticut | $141.34 | — |
| DelawareDelaware | $130.46 | — |
| Fort Lauderdale, FLFlorida | $135.26 | — |
| Rest of FloridaFlorida | $128.23 | — |
| Atlanta, GAGeorgia | $134.23 | — |
| Rest of GeorgiaGeorgia | $120.41 | — |
| Hawaii, Guam, HIHawaii | $146.14 | — |
| IowaIowa | $121.10 | — |
| IdahoIdaho | $121.83 | — |
| East St. Louis, ILIllinois | $125.43 | — |
| Rest of IllinoisIllinois | $123.60 | — |
| Suburban Chicago, ILIllinois | $136.86 | — |
| IndianaIndiana | $122.64 | — |
| KansasKansas | $120.13 | — |
| KentuckyKentucky | $119.43 | — |
| New Orleans, LALouisiana | $125.71 | — |
| Rest of LouisianaLouisiana | $119.08 | — |
| Metropolitan Boston, MAMassachusetts | $153.96 | — |
| Rest of MassachusettsMassachusetts | $137.64 | — |
| Baltimore area, MDMaryland | $140.88 | — |
| Rest of MarylandMaryland | $133.26 | — |
| Rest of MaineMaine | $122.18 | — |
| Southern Maine, MEMaine | $130.07 | — |
| Detroit, MIMichigan | $129.66 | — |
| Rest of MichiganMichigan | $122.59 | — |
| MinnesotaMinnesota | $133.50 | — |
| Metropolitan Kansas City, MOMissouri | $125.12 | — |
| Metropolitan St. Louis, MOMissouri | $126.62 | — |
| Rest of MissouriMissouri | $116.57 | — |
| MississippiMississippi | $115.91 | — |
| North CarolinaNorth Carolina | $123.66 | — |
| North DakotaNorth Dakota | $130.54 | — |
| NebraskaNebraska | $121.94 | — |
| New HampshireNew Hampshire | $136.19 | — |
| Northern New JerseyNew Jersey | $151.01 | — |
| Rest of New JerseyNew Jersey | $143.11 | — |
| New MexicoNew Mexico | $123.20 | — |
| NevadaNevada | $131.65 | — |
| NYC suburbs and Long Island, NYNew York | $156.09 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $143.80 | — |
| Queens, NYNew York | $154.35 | — |
| Rest of New YorkNew York | $125.69 | — |
| OhioOhio | $122.30 | — |
| OklahomaOklahoma | $119.55 | — |
| Portland, OROregon | $143.94 | — |
| Rest of OregonOregon | $130.80 | — |
| Metropolitan Philadelphia, PAPennsylvania | $137.27 | — |
| Rest of PennsylvaniaPennsylvania | $122.71 | — |
| Puerto RicoPuerto Rico | $133.12 | — |
| Rhode IslandRhode Island | $135.70 | — |
| South CarolinaSouth Carolina | $123.16 | — |
| South DakotaSouth Dakota | $130.38 | — |
| TennesseeTennessee | $120.76 | — |
| Austin, TXTexas | $138.14 | — |
| Beaumont, TXTexas | $121.79 | — |
| Brazoria, TXTexas | $130.57 | — |
| Dallas, TXTexas | $131.33 | — |
| Fort Worth, TXTexas | $130.25 | — |
| Galveston, TXTexas | $130.90 | — |
| Houston, TXTexas | $132.19 | — |
| Rest of TexasTexas | $126.05 | — |
| UtahUtah | $125.04 | — |
| VirginiaVirginia | $129.36 | — |
| Virgin Islands, VIUnited States Virgin Islands | $133.12 | — |
| VermontVermont | $129.67 | — |
| Rest of WashingtonWashington | $137.50 | — |
| King County, WAWashington | $157.61 | — |
| WisconsinWisconsin | $125.66 | — |
| West VirginiaWest Virginia | $118.41 | — |
| WyomingWyoming | $131.33 | — |
78216 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.
$115.16
$161.87
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 | $147.44 | 1 |
| AL | $117.06 | 1 |
| AR | $115.16 | 1 |
| AZ | $128.16 | 1 |
| CA | $141.81–$181.92 | 29 |
| CO | $138.74 | 1 |
| CT | $141.34 | 1 |
| DC | $152.95 | 1 |
| DE | $130.46 | 1 |
| FL | $128.23–$140.05 | 3 |
| GA | $120.41–$134.23 | 2 |
| GU | $146.14 | 1 |
| HI | $146.14 | 1 |
| IA | $121.10 | 1 |
| ID | $121.83 | 1 |
| IL | $123.60–$136.86 | 4 |
| IN | $122.64 | 1 |
| KS | $120.13 | 1 |
| KY | $119.43 | 1 |
| LA | $119.08–$125.71 | 2 |
| MA | $137.64–$153.96 | 2 |
| MD | $133.26–$152.95 | 3 |
| ME | $122.18–$130.07 | 2 |
| MI | $122.59–$129.66 | 2 |
| MN | $133.50 | 1 |
| MO | $116.57–$126.62 | 3 |
| MS | $115.91 | 1 |
| MT | $131.93 | 1 |
| NC | $123.66 | 1 |
| ND | $130.54 | 1 |
| NE | $121.94 | 1 |
| NH | $136.19 | 1 |
| NJ | $143.11–$151.01 | 2 |
| NM | $123.20 | 1 |
| NV | $131.65 | 1 |
| NY | $125.69–$156.09 | 5 |
| OH | $122.30 | 1 |
| OK | $119.55 | 1 |
| OR | $130.80–$143.94 | 2 |
| PA | $122.71–$137.27 | 2 |
| PR | $133.12 | 1 |
| RI | $135.70 | 1 |
| SC | $123.16 | 1 |
| SD | $130.38 | 1 |
| TN | $120.76 | 1 |
| TX | $121.79–$138.14 | 8 |
| UT | $125.04 | 1 |
| VA | $129.36–$152.95 | 2 |
| VI | $133.12 | 1 |
| VT | $129.67 | 1 |
| WA | $137.50–$157.61 | 2 |
| WI | $125.66 | 1 |
| WV | $118.41 | 1 |
| WY | $131.33 | 1 |
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.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,266
- Code
- 78216
- Physician work
- 0.56
- Practice expense
- 3.32
- Malpractice
- 0.07
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.56 | × 1.000 | 0.5600 |
| Practice expense | 3.32 | × 1.000 | 3.3200 |
| Malpractice | 0.07 | × 0.998 | 0.0699 |
| Total RVUs | 3.9499 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$131.93
Office: (0.56 × 1 + 3.32 × 1 + 0.07 × 0.998) × $33.4009 = $131.93
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.
How 78216 has changed in Montana
78216 · Office / nonfacility
$131.93
Effective 2026-10-01
The base rate is $0.33 higher than on 2025-10-01, moving from $131.60 to $131.93 (0.3%).
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
$131.60changed to$131.93
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.57 changed to 0.56
- Practice expense RVU 3.43 changed to 3.32
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$127.44changed to$131.60
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.19 changed to 3.43
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$125.36changed to$127.44
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$130.41changed to$125.36
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.20 changed to 3.19
- Malpractice RVU 0.08 changed to 0.07
January 1, 2023
RVU23A
$131.46changed to$130.41
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.17 changed to 3.20
- Malpractice RVU 0.06 changed to 0.08
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$132.55changed to$131.46
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$133.94changed to$132.55
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.05 changed to 3.17
- Malpractice RVU 0.07 changed to 0.06
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$133.99changed to$133.94
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.06 changed to 0.07
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$134.56changed to$133.99
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.07 changed to 3.05
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$133.71changed to$134.56
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$131.53changed to$133.71
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.03 changed to 3.07
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$131.29changed to$131.53
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.01 changed to 3.03
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$130.63changed to$131.29
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$125.73changed to$130.63
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.87 changed to 3.01
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$126.78changed to$125.73
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.09 changed to 2.87
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $126.78
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $131.93 | Not available in this setting | RVU26D |
| 2026-07-01 | $131.93 | Not available in this setting | RVU26C |
| 2026-04-01 | $131.93 | Not available in this setting | RVU26B |
| 2026-01-01 | $131.93 | Not available in this setting | RVU26A |
| 2025-10-01 | $131.60 | Not available in this setting | RVU25D |
| 2025-07-01 | $131.60 | Not available in this setting | RVU25C |
| 2025-04-01 | $131.60 | Not available in this setting | RVU25B |
| 2025-01-01 | $131.60 | Not available in this setting | RVU25A |
| 2024-10-01 | $127.44 | Not available in this setting | RVU24D |
| 2024-07-01 | $127.44 | Not available in this setting | RVU24C |
| 2024-04-01 | $127.44 | Not available in this setting | RVU24B |
| 2024-03-09 | $127.44 | Not available in this setting | RVU24AR |
| 2024-01-01 | $125.36 | Not available in this setting | RVU24A |
| 2023-10-01 | $130.41 | Not available in this setting | RVU23D |
| 2023-07-01 | $130.41 | Not available in this setting | RVU23C |
| 2023-04-01 | $130.41 | Not available in this setting | RVU23B |
| 2023-01-01 | $130.41 | Not available in this setting | RVU23A |
| 2022-10-01 | $131.46 | Not available in this setting | RVU22D |
| 2022-07-01 | $131.46 | Not available in this setting | RVU22C |
| 2022-04-01 | $131.46 | Not available in this setting | RVU22B |
| 2022-01-01 | $131.46 | Not available in this setting | RVU22A |
| 2021-10-01 | $132.55 | Not available in this setting | RVU21D |
| 2021-07-01 | $132.55 | Not available in this setting | RVU21C |
| 2021-04-01 | $132.55 | Not available in this setting | RVU21B |
| 2021-01-01 | $132.55 | Not available in this setting | RVU21A |
| 2020-10-01 | $133.94 | Not available in this setting | RVU20D |
| 2020-07-01 | $133.94 | Not available in this setting | RVU20C |
| 2020-04-01 | $133.94 | Not available in this setting | RVU20B |
| 2020-01-01 | $133.94 | Not available in this setting | RVU20A |
| 2019-10-01 | $133.99 | Not available in this setting | RVU19D |
| 2019-07-01 | $133.99 | Not available in this setting | RVU19C |
| 2019-04-01 | $133.99 | Not available in this setting | RVU19B |
| 2019-01-01 | $133.99 | Not available in this setting | RVU19A |
| 2018-10-01 | $134.56 | Not available in this setting | RVU18D |
| 2018-07-01 | $134.56 | Not available in this setting | RVU18C |
| 2018-04-01 | $134.56 | Not available in this setting | RVU18B |
| 2018-01-01 | $134.56 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $133.71 | Not available in this setting | RVU17D |
| 2017-07-01 | $133.71 | Not available in this setting | RVU17C |
| 2017-04-01 | $133.71 | Not available in this setting | RVU17B |
| 2017-01-01 | $133.71 | Not available in this setting | RVU17A |
| 2016-10-01 | $131.53 | Not available in this setting | RVU16D |
| 2016-07-01 | $131.53 | Not available in this setting | RVU16C |
| 2016-04-01 | $131.53 | Not available in this setting | RVU16B |
| 2016-01-01 | $131.53 | Not available in this setting | RVU16A |
| 2015-10-01 | $131.29 | Not available in this setting | RVU15D |
| 2015-07-01 | $131.29 | Not available in this setting | RVU15C |
| 2015-04-01 | $130.63 | Not available in this setting | RVU15B |
| 2015-01-01 | $130.63 | Not available in this setting | RVU15A |
| 2014-10-01 | $125.73 | Not available in this setting | RVU14D |
| 2014-07-01 | $125.73 | Not available in this setting | RVU14C |
| 2014-04-01 | $125.73 | Not available in this setting | RVU14B |
| 2014-01-01 | $125.73 | Not available in this setting | RVU14A |
| 2013-10-01 | $126.78 | Not available in this setting | RVU13D |
| 2013-07-01 | $126.78 | Not available in this setting | RVU13C |
| 2013-04-01 | $126.78 | Not available in this setting | RVU13B |
| 2013-01-01 | $126.78 | Not available in this setting | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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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