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CPT code 78226: Hepatobiliary imaging, without drug intervention2026 Medicare rate & RVUs in Washington, DC area

Reports radiotracer imaging of bile flow through the liver and biliary system, including gallbladder visualization, for suspected obstruction, inflammation, or bile leak.

CMS RVU26DEffective Oct 1, 2026One payment locality42.8K Medicare services in 2024

In Washington, DC area, Medicare pays $332.45 for 78226 in the office.

$332.45Office (non-facility)
Not available in this settingHospital or facility
+16.7%vs the national office rate ($284.91)

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.

We’ll open 78226 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 78226 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 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 Washington, DC area 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. Washington, DC area pays $332.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

78226 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$332.45
  2. Los Angeles, CA · California$332.07−$0.38
  3. Miami, FL · Florida$300.08−$32.37
  4. Chicago, IL · Illinois$290.26−$42.19
  5. Manhattan, NY · New York$329.98−$2.47
  6. Alaska · Alaska$312.34−$20.11
  7. Alabama · Alabama$251.37−$81.08

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

78226 in every other Medicare payment locality
Payment localityOfficeFacility
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—

78226 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
78226 office rate range by state
State / territoryOffice rate rangeLocalities
AK$312.341
AL$251.371
AR$247.091
AZ$276.481
CA$308.68–$400.1329
CO$301.041
CT$305.881
DC$332.451
DE$281.631
FL$275.08–$300.083
GA$257.64–$289.712
GU$318.971
HI$318.971
IA$261.181
ID$262.701
IL$264.17–$294.364
IN$264.541
KS$258.661
KY$256.031
LA$255.13–$270.112
MA$298.35–$335.592
MD$288.00–$332.453
ME$263.14–$281.482
MI$262.86–$277.952
MN$290.271
MO$249.25–$272.543
MS$248.281
MT$284.901
NC$266.551
ND$283.121
NE$263.191
NH$295.111
NJ$309.89–$327.892
NM$264.111
NV$284.671
NY$271.12–$337.765
OH$262.501
OK$256.651
OR$282.99–$313.152
PA$263.60–$296.492
PR$287.701
RI$293.551
SC$264.861
SD$282.911
TN$260.051
TX$261.49–$299.578
UT$269.131
VA$279.64–$332.452
VI$287.701
VT$280.851
WA$298.17–$344.102
WI$272.001
WV$252.431
WY$284.131

See 78226 in every payment locality

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

Office or facility?

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 78226 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.72× 1.0540.7589
Practice expense7.72× 1.1789.0942
Malpractice0.09× 1.1130.1002
Total RVUs9.9532
Conversion factor× 33.4009

Office rate, Washington, DC area$332.45

Office: (0.72 × 1.054 + 7.72 × 1.178 + 0.09 × 1.113) × $33.4009 = $332.45

Open 78226 in the RVU calculator

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

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

78226 without 26 · national office

$284.91

Hepatobiliary imaging, without drug intervention

78226-26 · Professional component

$33.73

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78226

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78226
CodeHow it relatesOffice range, Washington, DC area
Used instead
78227Hepatobiliary scan, with pharmacologic interventionUse for hepatobiliary imaging that includes pharmacologic intervention.$447.00
78201Liver imaging, static images onlyLiver-focused static imaging rather than hepatobiliary tracer transit.$200.33
78215Liver-spleen scan, static images onlyImages liver and spleen when that is the study's target.$207.97
78216Liver-spleen scan, with vascular flowImages liver and spleen with vascular-flow assessment.$152.95

How 78226 has changed in Washington, DC area

78226 · Office / nonfacility

$332.45

Effective 2026-10-01

The base rate is $0.30 higher than on 2025-10-01, moving from $332.15 to $332.45 (0.1%).

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

    $332.15changed to$332.45

    • 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
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $349.74changed to$332.15

    • 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.

  3. March 9, 2024

    RVU24AR

    $344.03changed to$349.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $369.22changed to$344.03

    • 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
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $389.46changed to$369.22

    • 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
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $410.80changed to$389.46

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.80 changed to 8.38

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $408.90changed to$410.80

    • 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
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $409.32changed to$408.90

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.70 changed to 8.56
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $417.11changed to$409.32

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.89 changed to 8.70

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $414.64changed to$417.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.86 changed to 8.89
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $413.34changed to$414.64

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.85 changed to 8.86
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $412.64changed to$413.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.81 changed to 8.85
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $410.59changed to$412.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $402.89changed to$410.59

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.64 changed to 8.81
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$402.89

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$332.45Not available in this settingRVU26D
2026-07-01$332.45Not available in this settingRVU26C
2026-04-01$332.45Not available in this settingRVU26B
2026-01-01$332.45Not available in this settingRVU26A
2025-10-01$332.15Not available in this settingRVU25D
2025-07-01$332.15Not available in this settingRVU25C
2025-04-01$332.15Not available in this settingRVU25B
2025-01-01$332.15Not available in this settingRVU25A
2024-10-01$349.74Not available in this settingRVU24D
2024-07-01$349.74Not available in this settingRVU24C
2024-04-01$349.74Not available in this settingRVU24B
2024-03-09$349.74Not available in this settingRVU24AR
2024-01-01$344.03Not available in this settingRVU24A
2023-10-01$369.22Not available in this settingRVU23D
2023-07-01$369.22Not available in this settingRVU23C
2023-04-01$369.22Not available in this settingRVU23B
2023-01-01$369.22Not available in this settingRVU23A
2022-10-01$389.46Not available in this settingRVU22D
2022-07-01$389.46Not available in this settingRVU22C
2022-04-01$389.46Not available in this settingRVU22B
2022-01-01$389.46Not available in this settingRVU22A
2021-10-01$410.80Not available in this settingRVU21D
2021-07-01$410.80Not available in this settingRVU21C
2021-04-01$410.80Not available in this settingRVU21B
2021-01-01$410.80Not available in this settingRVU21A
2020-10-01$408.90Not available in this settingRVU20D
2020-07-01$408.90Not available in this settingRVU20C
2020-04-01$408.90Not available in this settingRVU20B
2020-01-01$408.90Not available in this settingRVU20A
2019-10-01$409.32Not available in this settingRVU19D
2019-07-01$409.32Not available in this settingRVU19C
2019-04-01$409.32Not available in this settingRVU19B
2019-01-01$409.32Not available in this settingRVU19A
2018-10-01$417.11Not available in this settingRVU18D
2018-07-01$417.11Not available in this settingRVU18C
2018-04-01$417.11Not available in this settingRVU18B
2018-01-01$417.11Not available in this settingRVU18AR1
2017-10-01$414.64Not available in this settingRVU17D
2017-07-01$414.64Not available in this settingRVU17C
2017-04-01$414.64Not available in this settingRVU17B
2017-01-01$414.64Not available in this settingRVU17A
2016-10-01$413.34Not available in this settingRVU16D
2016-07-01$413.34Not available in this settingRVU16C
2016-04-01$413.34Not available in this settingRVU16B
2016-01-01$413.34Not available in this settingRVU16A
2015-10-01$412.64Not available in this settingRVU15D
2015-07-01$412.64Not available in this settingRVU15C
2015-04-01$410.59Not available in this settingRVU15B
2015-01-01$410.59Not available in this settingRVU15A
2014-10-01$402.89Not available in this settingRVU14D
2014-07-01$402.89Not available in this settingRVU14C
2014-04-01$402.89Not available in this settingRVU14B
2014-01-01$402.89Not available in this settingRVU14A
2013-10-01Additional calculation requiredNot available in this settingRVU13D
2013-07-01Additional calculation requiredNot available in this settingRVU13C
2013-04-01Additional calculation requiredNot available in this settingRVU13B
2013-01-01Additional calculation requiredNot available in this settingRVU13AR

Price 78226 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 78226PPRRVU2026_Oct_nonQPP.csv, line 9,269 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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