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

Nuclear medicine imaging of liver and spleen with vascular-flow acquisition, reported when a study evaluates perfusion along with radiopharmaceutical distribution in both organs.

CMS RVU26DEffective Oct 1, 2026One payment locality62 Medicare services in 2024

In New Mexico, Medicare pays $123.20 for 78216 in the office.

$123.20Office (non-facility)
Not available in this settingHospital or facility
−6.6%vs the national office rate ($131.93)

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.

We’ll open 78216 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 78216 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 New Mexico 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. New Mexico pays $123.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

78216 in New Mexico vs other payment areas
  1. New Mexico · this page$123.20
  2. Los Angeles, CA · California$152.21+$29.01
  3. Washington, DC area · District of Columbia$152.95+$29.75
  4. Miami, FL · Florida$140.05+$16.85
  5. Chicago, IL · Illinois$135.65+$12.45
  6. Manhattan, NY · New York$152.47+$29.27
  7. Alaska · Alaska$147.44+$24.24

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

78216 in every other Medicare payment locality
Payment localityOfficeFacility
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—

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
78216 office rate range by state
State / territoryOffice rate rangeLocalities
AK$147.441
AL$117.061
AR$115.161
AZ$128.161
CA$141.81–$181.9229
CO$138.741
CT$141.341
DC$152.951
DE$130.461
FL$128.23–$140.053
GA$120.41–$134.232
GU$146.141
HI$146.141
IA$121.101
ID$121.831
IL$123.60–$136.864
IN$122.641
KS$120.131
KY$119.431
LA$119.08–$125.712
MA$137.64–$153.962
MD$133.26–$152.953
ME$122.18–$130.072
MI$122.59–$129.662
MN$133.501
MO$116.57–$126.623
MS$115.911
MT$131.931
NC$123.661
ND$130.541
NE$121.941
NH$136.191
NJ$143.11–$151.012
NM$123.201
NV$131.651
NY$125.69–$156.095
OH$122.301
OK$119.551
OR$130.80–$143.942
PA$122.71–$137.272
PR$133.121
RI$135.701
SC$123.161
SD$130.381
TN$120.761
TX$121.79–$138.148
UT$125.041
VA$129.36–$152.952
VI$133.121
VT$129.671
WA$137.50–$157.612
WI$125.661
WV$118.411
WY$131.331

See 78216 in every payment locality

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

Office or facility?

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 78216 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.56× 1.0000.5600
Practice expense3.32× 0.9173.0444
Malpractice0.07× 1.2010.0841
Total RVUs3.6885
Conversion factor× 33.4009

Office rate, New Mexico$123.20

Office: (0.56 × 1 + 3.32 × 0.917 + 0.07 × 1.201) × $33.4009 = $123.20

Open 78216 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

How 78216 has changed in New Mexico

78216 · Office / nonfacility

$123.20

Effective 2026-10-01

The base rate is $1.37 higher than on 2025-10-01, moving from $121.83 to $123.20 (1.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $121.83changed to$123.20

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $118.12changed to$121.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.19 changed to 3.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $116.19changed to$118.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $120.30changed to$116.19

    • 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
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $120.44changed to$120.30

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.44changed to$120.44

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $123.57changed to$121.44

    • 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
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $124.47changed to$123.57

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $125.00changed to$124.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.07 changed to 3.05

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $124.41changed to$125.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $122.60changed to$124.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.03 changed to 3.07
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $122.38changed to$122.60

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.01 changed to 3.03

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $121.78changed to$122.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $117.12changed to$121.78

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.87 changed to 3.01
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $117.73changed to$117.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.09 changed to 2.87
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $117.73

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$123.20Not available in this settingRVU26D
2026-07-01$123.20Not available in this settingRVU26C
2026-04-01$123.20Not available in this settingRVU26B
2026-01-01$123.20Not available in this settingRVU26A
2025-10-01$121.83Not available in this settingRVU25D
2025-07-01$121.83Not available in this settingRVU25C
2025-04-01$121.83Not available in this settingRVU25B
2025-01-01$121.83Not available in this settingRVU25A
2024-10-01$118.12Not available in this settingRVU24D
2024-07-01$118.12Not available in this settingRVU24C
2024-04-01$118.12Not available in this settingRVU24B
2024-03-09$118.12Not available in this settingRVU24AR
2024-01-01$116.19Not available in this settingRVU24A
2023-10-01$120.30Not available in this settingRVU23D
2023-07-01$120.30Not available in this settingRVU23C
2023-04-01$120.30Not available in this settingRVU23B
2023-01-01$120.30Not available in this settingRVU23A
2022-10-01$120.44Not available in this settingRVU22D
2022-07-01$120.44Not available in this settingRVU22C
2022-04-01$120.44Not available in this settingRVU22B
2022-01-01$120.44Not available in this settingRVU22A
2021-10-01$121.44Not available in this settingRVU21D
2021-07-01$121.44Not available in this settingRVU21C
2021-04-01$121.44Not available in this settingRVU21B
2021-01-01$121.44Not available in this settingRVU21A
2020-10-01$123.57Not available in this settingRVU20D
2020-07-01$123.57Not available in this settingRVU20C
2020-04-01$123.57Not available in this settingRVU20B
2020-01-01$123.57Not available in this settingRVU20A
2019-10-01$124.47Not available in this settingRVU19D
2019-07-01$124.47Not available in this settingRVU19C
2019-04-01$124.47Not available in this settingRVU19B
2019-01-01$124.47Not available in this settingRVU19A
2018-10-01$125.00Not available in this settingRVU18D
2018-07-01$125.00Not available in this settingRVU18C
2018-04-01$125.00Not available in this settingRVU18B
2018-01-01$125.00Not available in this settingRVU18AR1
2017-10-01$124.41Not available in this settingRVU17D
2017-07-01$124.41Not available in this settingRVU17C
2017-04-01$124.41Not available in this settingRVU17B
2017-01-01$124.41Not available in this settingRVU17A
2016-10-01$122.60Not available in this settingRVU16D
2016-07-01$122.60Not available in this settingRVU16C
2016-04-01$122.60Not available in this settingRVU16B
2016-01-01$122.60Not available in this settingRVU16A
2015-10-01$122.38Not available in this settingRVU15D
2015-07-01$122.38Not available in this settingRVU15C
2015-04-01$121.78Not available in this settingRVU15B
2015-01-01$121.78Not available in this settingRVU15A
2014-10-01$117.12Not available in this settingRVU14D
2014-07-01$117.12Not available in this settingRVU14C
2014-04-01$117.12Not available in this settingRVU14B
2014-01-01$117.12Not available in this settingRVU14A
2013-10-01$117.73Not available in this settingRVU13D
2013-07-01$117.73Not available in this settingRVU13C
2013-04-01$117.73Not available in this settingRVU13B
2013-01-01$117.73Not available in this settingRVU13AR

Price 78216 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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
RVUs for 78216PPRRVU2026_Oct_nonQPP.csv, line 9,266 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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