CPT code 78258: Esophageal motility, radionuclide transit study2026 Medicare rate & RVUs in Illinois
Reports radionuclide assessment of esophageal transit when a clinician evaluates impaired esophageal movement, such as in a patient with dysphagia.
Medicare pays $191.37–$212.47 for 78258 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 78258 covers
This nuclear medicine study evaluates how material moves through the esophagus. The patient swallows a radiotracer-containing bolus while a gamma camera records its passage; the resulting images help assess esophageal transit in a patient with symptoms such as dysphagia or suspected motility impairment. Nuclear medicine staff typically perform the imaging, and a physician interprets the findings. It is distinct from pressure-based esophageal manometry.
Report the study when the record supports a radionuclide evaluation of esophageal movement, rather than a reflux or gastric-emptying assessment. Documentation should identify the clinical reason, the imaging performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Reporting without either modifier represents the global service.
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 78258 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$191.37 to $212.47
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $209.94 | Unavailable |
| East St. Louis, IL | $193.83 | Unavailable |
| Rest of Illinois | $191.37 | Unavailable |
| Suburban Chicago, IL | $212.47 | Unavailable |
How the 78258 rate is calculated
Each of 78258’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 · 78258
RVUs × geographic indexes × conversion factor
Work0.72
0.72 RVUs× 1.000 GPCI
Practice expense5.35
5.35 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
6.1500
Conversion factor
$33.4009
Medicare rate
$205.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78258
The CMS indicators that decide how 78258 is paid alongside other services.
CMS payment indicators · 78258
Esophageal motility, radionuclide transit study
| 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
78258 without 26 · national office
$205.42
Esophageal motility, radionuclide transit study
78258-26 · Professional component
$33.73
Pays only the interpretation and report.
78258 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78262Reflux imagingGastroesophageal reflux
- 78258 evaluates esophageal transit by radionuclide imaging; 78262 is focused on gastroesophageal reflux.
- 91010Esophageal manometryStandard pressure study
- Report 91010 for catheter-based esophageal pressure and motility measurement. Report 78258 for radionuclide imaging of esophageal transit.
- 78264Gastric emptyingStomach only
- 78264 evaluates gastric emptying, not movement through the esophagus. Select according to the anatomic region and functional question studied.
78258 billing questions
How is this different from esophageal manometry?
This code represents radionuclide imaging of esophageal transit. Manometry, reported with 91010, measures pressure and coordination using a catheter rather than imaging a swallowed tracer.
When should 78262 be considered instead?
Use 78262 for a radionuclide study focused on gastroesophageal reflux. Use 78258 when the clinical question is esophageal movement or transit.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff portion. Without either modifier, the claim represents the global service.
What documentation supports reporting 78258?
The record should support a radionuclide esophageal transit evaluation and include the clinical indication, imaging performed, and interpretation. Dysphagia or suspected impaired esophageal movement may support the study when documented.
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
Fee sheets · Coming soon
Put 78258 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist