CPT code 78226: Hepatobiliary imaging, without drug intervention2026 Medicare rate & RVUs

Medicare pays $284.91 for 78226 nationally in the office. Local office rates run $247.09–$400.13.

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

What 78226 covers

This nuclear medicine study tracks an injected radiotracer as the liver takes it up and excretes it into the bile ducts, gallbladder when present, and bowel. A technologist acquires the gamma-camera images, and a radiologist or nuclear medicine physician interprets them. Common clinical questions include suspected acute cholecystitis, impaired bile flow, or a postoperative bile leak. The study is performed without the pharmacologic intervention represented by the related drug-assisted code.

Select this code for hepatobiliary imaging based on the documented study performed, not simply because the patient has a liver or gallbladder diagnosis. The order and report should support the clinical question and identify the imaging performed and findings. CMS recognizes separate professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier when billing 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 78226 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

78226 rates by state

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

How the 78226 rate is calculated

Each of 78226’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 78226

The CMS indicators that decide how 78226 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78226 compared with similar codes

How to choose

78227Hepatobiliary scanWith pharmacologic intervention

Both address hepatobiliary imaging, but 78227 is for a study with pharmacologic intervention; 78226 is for imaging without it.

78201Liver imagingStatic images only

78201 is static liver imaging. Choose 78226 when the study follows tracer through the hepatobiliary system, including gallbladder visualization when performed.

78202Liver imagingWith vascular-flow phase

78202 adds vascular-flow assessment to liver imaging. It is not the hepatobiliary transit study described by 78226.

Codes related to 78226

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