CPT code 78226: Hepatobiliary imaging, without drug intervention2026 Medicare rate & RVUs in Alabama
Reports radiotracer imaging of bile flow through the liver and biliary system, including gallbladder visualization, for suspected obstruction, inflammation, or bile leak.
In Alabama, Medicare pays $251.37 for 78226 in the office.
Check a contract rate as a % of Medicare · 78226 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 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.
How Alabama compares for 78226
Across 109 of 109 payment localities, the office rate for 78226 runs from $247.09 in Arkansas to $400.13 in San Benito County, CA. Alabama pays $251.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$251.37
- Los Angeles, CA · California$332.07+$80.70
- Washington, DC area · District of Columbia$332.45+$81.08
- Miami, FL · Florida$300.08+$48.71
- Chicago, IL · Illinois$290.26+$38.89
- Manhattan, NY · New York$329.98+$78.61
- Alaska · Alaska$312.34+$60.97
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $247.09 | — |
| ArizonaArizona | $276.48 | — |
| Bakersfield, CACalifornia | $308.95 | — |
| Chico, CACalifornia | $308.68 | — |
| El Centro, CACalifornia | $308.69 | — |
| Fresno, CACalifornia | $308.68 | — |
| Hanford, CACalifornia | $308.68 | — |
| Madera, CACalifornia | $308.68 | — |
| Merced, CACalifornia | $308.68 | — |
| Modesto, CACalifornia | $308.68 | — |
| Napa, CACalifornia | $366.94 | — |
| Oxnard, CACalifornia | $331.38 | — |
| Redding, CACalifornia | $308.68 | — |
| Rest of CaliforniaCalifornia | $308.68 | — |
| Riverside, CACalifornia | $309.65 | — |
| Sacramento, CACalifornia | $326.41 | — |
| Salinas, CACalifornia | $325.26 | — |
| San Diego, CACalifornia | $334.79 | — |
| Marin County, CACalifornia | $391.29 | — |
| San Francisco, CACalifornia | $391.19 | — |
| San Benito County, CACalifornia | $400.13 | — |
| Santa Clara County, CACalifornia | $399.71 | — |
| San Luis Obispo, CACalifornia | $319.77 | — |
| Santa Cruz, CACalifornia | $339.46 | — |
| Santa Maria, CACalifornia | $326.99 | — |
| Santa Rosa, CACalifornia | $343.03 | — |
| Stockton, CACalifornia | $308.68 | — |
| Vallejo, CACalifornia | $366.80 | — |
| Visalia, CACalifornia | $308.68 | — |
| Yuba City, CACalifornia | $308.68 | — |
| ColoradoColorado | $301.04 | — |
| ConnecticutConnecticut | $305.88 | — |
| DelawareDelaware | $281.63 | — |
| Fort Lauderdale, FLFlorida | $290.69 | — |
| Rest of FloridaFlorida | $275.08 | — |
| Atlanta, GAGeorgia | $289.71 | — |
| Rest of GeorgiaGeorgia | $257.64 | — |
| Hawaii, Guam, HIHawaii | $318.97 | — |
| IowaIowa | $261.18 | — |
| IdahoIdaho | $262.70 | — |
| East St. Louis, ILIllinois | $267.33 | — |
| Rest of IllinoisIllinois | $264.17 | — |
| Suburban Chicago, ILIllinois | $294.36 | — |
| IndianaIndiana | $264.54 | — |
| KansasKansas | $258.66 | — |
| KentuckyKentucky | $256.03 | — |
| New Orleans, LALouisiana | $270.11 | — |
| Rest of LouisianaLouisiana | $255.13 | — |
| Metropolitan Boston, MAMassachusetts | $335.59 | — |
| Rest of MassachusettsMassachusetts | $298.35 | — |
| Baltimore area, MDMaryland | $304.83 | — |
| Rest of MarylandMaryland | $288.00 | — |
| Rest of MaineMaine | $263.14 | — |
| Southern Maine, MEMaine | $281.48 | — |
| Detroit, MIMichigan | $277.95 | — |
| Rest of MichiganMichigan | $262.86 | — |
| MinnesotaMinnesota | $290.27 | — |
| Metropolitan Kansas City, MOMissouri | $269.11 | — |
| Metropolitan St. Louis, MOMissouri | $272.54 | — |
| Rest of MissouriMissouri | $249.25 | — |
| MississippiMississippi | $248.28 | — |
| MontanaMontana | $284.90 | — |
| North CarolinaNorth Carolina | $266.55 | — |
| North DakotaNorth Dakota | $283.12 | — |
| NebraskaNebraska | $263.19 | — |
| New HampshireNew Hampshire | $295.11 | — |
| Northern New JerseyNew Jersey | $327.89 | — |
| Rest of New JerseyNew Jersey | $309.89 | — |
| New MexicoNew Mexico | $264.11 | — |
| NevadaNevada | $284.67 | — |
| NYC suburbs and Long Island, NYNew York | $337.76 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $311.12 | — |
| Queens, NYNew York | $334.71 | — |
| Rest of New YorkNew York | $271.12 | — |
| OhioOhio | $262.50 | — |
| OklahomaOklahoma | $256.65 | — |
| Portland, OROregon | $313.15 | — |
| Rest of OregonOregon | $282.99 | — |
| Metropolitan Philadelphia, PAPennsylvania | $296.49 | — |
| Rest of PennsylvaniaPennsylvania | $263.60 | — |
| Puerto RicoPuerto Rico | $287.70 | — |
| Rhode IslandRhode Island | $293.55 | — |
| South CarolinaSouth Carolina | $264.86 | — |
| South DakotaSouth Dakota | $282.91 | — |
| TennesseeTennessee | $260.05 | — |
| Austin, TXTexas | $299.57 | — |
| Beaumont, TXTexas | $261.49 | — |
| Brazoria, TXTexas | $282.12 | — |
| Dallas, TXTexas | $283.67 | — |
| Fort Worth, TXTexas | $281.13 | — |
| Galveston, TXTexas | $282.78 | — |
| Houston, TXTexas | $284.43 | — |
| Rest of TexasTexas | $271.47 | — |
| UtahUtah | $269.13 | — |
| VirginiaVirginia | $279.64 | — |
| Virgin Islands, VIUnited States Virgin Islands | $287.70 | — |
| VermontVermont | $280.85 | — |
| Rest of WashingtonWashington | $298.17 | — |
| King County, WAWashington | $344.10 | — |
| WisconsinWisconsin | $272.00 | — |
| West VirginiaWest Virginia | $252.43 | — |
| WyomingWyoming | $284.13 | — |
78226 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.
$247.09
$354.41
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 | $312.34 | 1 |
| AL | $251.37 | 1 |
| AR | $247.09 | 1 |
| AZ | $276.48 | 1 |
| CA | $308.68–$400.13 | 29 |
| CO | $301.04 | 1 |
| CT | $305.88 | 1 |
| DC | $332.45 | 1 |
| DE | $281.63 | 1 |
| FL | $275.08–$300.08 | 3 |
| GA | $257.64–$289.71 | 2 |
| GU | $318.97 | 1 |
| HI | $318.97 | 1 |
| IA | $261.18 | 1 |
| ID | $262.70 | 1 |
| IL | $264.17–$294.36 | 4 |
| IN | $264.54 | 1 |
| KS | $258.66 | 1 |
| KY | $256.03 | 1 |
| LA | $255.13–$270.11 | 2 |
| MA | $298.35–$335.59 | 2 |
| MD | $288.00–$332.45 | 3 |
| ME | $263.14–$281.48 | 2 |
| MI | $262.86–$277.95 | 2 |
| MN | $290.27 | 1 |
| MO | $249.25–$272.54 | 3 |
| MS | $248.28 | 1 |
| MT | $284.90 | 1 |
| NC | $266.55 | 1 |
| ND | $283.12 | 1 |
| NE | $263.19 | 1 |
| NH | $295.11 | 1 |
| NJ | $309.89–$327.89 | 2 |
| NM | $264.11 | 1 |
| NV | $284.67 | 1 |
| NY | $271.12–$337.76 | 5 |
| OH | $262.50 | 1 |
| OK | $256.65 | 1 |
| OR | $282.99–$313.15 | 2 |
| PA | $263.60–$296.49 | 2 |
| PR | $287.70 | 1 |
| RI | $293.55 | 1 |
| SC | $264.86 | 1 |
| SD | $282.91 | 1 |
| TN | $260.05 | 1 |
| TX | $261.49–$299.57 | 8 |
| UT | $269.13 | 1 |
| VA | $279.64–$332.45 | 2 |
| VI | $287.70 | 1 |
| VT | $280.85 | 1 |
| WA | $298.17–$344.10 | 2 |
| WI | $272.00 | 1 |
| WV | $252.43 | 1 |
| WY | $284.13 | 1 |
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.
How the rate is built · 78226
RVUs × geographic indexes × conversion factor
Work0.72
0.72 RVUs× 1.000 GPCI
Practice expense7.72
7.72 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
8.5300
Conversion factor
$33.4009
Medicare rate
$284.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,269
- Code
- 78226
- Physician work
- 0.72
- Practice expense
- 7.72
- Malpractice
- 0.09
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.72 | × 1.000 | 0.7200 |
| Practice expense | 7.72 | × 0.875 | 6.7550 |
| Malpractice | 0.09 | × 0.566 | 0.0509 |
| Total RVUs | 7.5259 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$251.37
Office: (0.72 × 1 + 7.72 × 0.875 + 0.09 × 0.566) × $33.4009 = $251.37
Payment rules and modifiers for 78226
The CMS indicators that decide how 78226 is paid alongside other services.
CMS payment indicators · 78226
Hepatobiliary imaging, without drug intervention
| 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
78226 without 26 · national office
$284.91
Hepatobiliary imaging, without drug intervention
78226-26 · Professional component
$33.73
Pays only the interpretation and report.
How 78226 has changed in Alabama
78226 · Office / nonfacility
$251.37
Effective 2026-10-01
The base rate is $4.45 higher than on 2025-10-01, moving from $246.92 to $251.37 (1.8%).
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
$246.92changed to$251.37
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.74 changed to 0.72
- Practice expense RVU 7.88 changed to 7.72
- Malpractice RVU 0.08 changed to 0.09
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$259.79changed to$246.92
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.07 changed to 7.88
- Malpractice RVU 0.09 changed to 0.08
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$255.55changed to$259.79
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$272.57changed to$255.55
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.25 changed to 8.07
- Malpractice RVU 0.08 changed to 0.09
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$286.00changed to$272.57
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.38 changed to 8.25
- Malpractice RVU 0.09 changed to 0.08
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$301.38changed to$286.00
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.80 changed to 8.38
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$303.38changed to$301.38
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.56 changed to 8.80
- Malpractice RVU 0.08 changed to 0.09
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$307.14changed to$303.38
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.70 changed to 8.56
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$312.89changed to$307.14
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.89 changed to 8.70
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$312.89
Held through RVU18C, RVU18D.
January 1, 2014
RVU14A
No ratechanged toNo rate
Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $251.37 | Not available in this setting | RVU26D |
| 2026-07-01 | $251.37 | Not available in this setting | RVU26C |
| 2026-04-01 | $251.37 | Not available in this setting | RVU26B |
| 2026-01-01 | $251.37 | Not available in this setting | RVU26A |
| 2025-10-01 | $246.92 | Not available in this setting | RVU25D |
| 2025-07-01 | $246.92 | Not available in this setting | RVU25C |
| 2025-04-01 | $246.92 | Not available in this setting | RVU25B |
| 2025-01-01 | $246.92 | Not available in this setting | RVU25A |
| 2024-10-01 | $259.79 | Not available in this setting | RVU24D |
| 2024-07-01 | $259.79 | Not available in this setting | RVU24C |
| 2024-04-01 | $259.79 | Not available in this setting | RVU24B |
| 2024-03-09 | $259.79 | Not available in this setting | RVU24AR |
| 2024-01-01 | $255.55 | Not available in this setting | RVU24A |
| 2023-10-01 | $272.57 | Not available in this setting | RVU23D |
| 2023-07-01 | $272.57 | Not available in this setting | RVU23C |
| 2023-04-01 | $272.57 | Not available in this setting | RVU23B |
| 2023-01-01 | $272.57 | Not available in this setting | RVU23A |
| 2022-10-01 | $286.00 | Not available in this setting | RVU22D |
| 2022-07-01 | $286.00 | Not available in this setting | RVU22C |
| 2022-04-01 | $286.00 | Not available in this setting | RVU22B |
| 2022-01-01 | $286.00 | Not available in this setting | RVU22A |
| 2021-10-01 | $301.38 | Not available in this setting | RVU21D |
| 2021-07-01 | $301.38 | Not available in this setting | RVU21C |
| 2021-04-01 | $301.38 | Not available in this setting | RVU21B |
| 2021-01-01 | $301.38 | Not available in this setting | RVU21A |
| 2020-10-01 | $303.38 | Not available in this setting | RVU20D |
| 2020-07-01 | $303.38 | Not available in this setting | RVU20C |
| 2020-04-01 | $303.38 | Not available in this setting | RVU20B |
| 2020-01-01 | $303.38 | Not available in this setting | RVU20A |
| 2019-10-01 | $307.14 | Not available in this setting | RVU19D |
| 2019-07-01 | $307.14 | Not available in this setting | RVU19C |
| 2019-04-01 | $307.14 | Not available in this setting | RVU19B |
| 2019-01-01 | $307.14 | Not available in this setting | RVU19A |
| 2018-10-01 | $312.89 | Not available in this setting | RVU18D |
| 2018-07-01 | $312.89 | Not available in this setting | RVU18C |
| 2018-04-01 | $312.89 | Not available in this setting | RVU18B |
| 2018-01-01 | Rate data unavailable | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Not available in this setting | RVU17D |
| 2017-07-01 | Rate data unavailable | Not available in this setting | RVU17C |
| 2017-04-01 | Rate data unavailable | Not available in this setting | RVU17B |
| 2017-01-01 | Rate data unavailable | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Additional calculation required | Not available in this setting | RVU13D |
| 2013-07-01 | Additional calculation required | Not available in this setting | RVU13C |
| 2013-04-01 | Additional calculation required | Not available in this setting | RVU13B |
| 2013-01-01 | Additional calculation required | Not available in this setting | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
78226 billing questions
When should 78227 be used instead?
Use 78227 when the hepatobiliary study includes a pharmacologic intervention. Use 78226 for the corresponding imaging without that intervention.
Is this the code for a HIDA scan?
It commonly describes a HIDA-type hepatobiliary study that follows radiotracer through the liver and biliary system. Confirm that the performed study does not include the drug intervention associated with 78227.
How should the professional and technical portions be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Billing without either modifier represents the global service.
What documentation supports reporting 78226?
The record should identify the clinical question, the hepatobiliary imaging performed, and the interpreting findings. The report should make clear whether pharmacologic intervention was part of the study.
Is 78226 the same as liver-only imaging?
No. 78226 evaluates radiotracer movement through the hepatobiliary system; 78201 is for static liver imaging, and 78202 includes vascular-flow imaging.
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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