CPT code 78261: Gastric mucosa scan, ectopic tissue localization2026 Medicare rate & RVUs

Nuclear medicine imaging to locate functioning gastric-type tissue outside the stomach, commonly ordered when a Meckel diverticulum is suspected.

CMS RVU26DEffective Oct 1, 2026109 payment localities15 Medicare services in 2024

Medicare pays $183.70 for 78261 nationally in the office. Local office rates run $160.38–$255.96.

Medicare rate · 78261

Gastric mucosa scan, ectopic tissue localization

Office or facility?

Work RVUs
0.67
Total RVUs
5.50
Global days
XXX

National rate · 2026

$183.70

Office setting, before claim adjustments.

See every locality for 78261 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Medicare rate
  2. What 78261 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Billing questions
  9. Sources

What 78261 covers

This nuclear medicine study uses a radiotracer that is taken up by functioning gastric mucosa to identify gastric-type tissue in an abnormal location. A common clinical question is whether a child or adult with gastrointestinal bleeding has a Meckel diverticulum containing ectopic gastric mucosa. A nuclear medicine technologist performs the imaging, and a qualified physician interprets the images and reports the findings, commonly in a hospital or imaging facility.

Report 78261 when the study is directed at localizing ectopic functioning gastric mucosa, rather than measuring stomach emptying or evaluating reflux. The record should support the clinical indication and include the imaging findings and physician interpretation. CMS recognizes separately priced professional and technical components: report modifier 26 for the interpretation, TC for the equipment and staff portion, or neither modifier when billing 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 78261 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$160.38 to $255.96

$160.38$208.17$255.96
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

78261 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$163.02Unavailable
Alaska$204.52Unavailable
Arizona$178.52Unavailable
Arkansas$160.38Unavailable
Atlanta, GA$186.66Unavailable
Austin, TX$192.82Unavailable
Bakersfield, CA$198.80Unavailable
Baltimore area, MD$196.11Unavailable
Beaumont, TX$169.22Unavailable
Brazoria, TX$182.08Unavailable

78261 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.

$160.38

$227.30

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78261 office rate range by state
State / territoryOffice rate rangeLocalities
AK$204.521
AL$163.021
AR$160.381
AZ$178.521
CA$198.64–$255.9629
CO$193.831
CT$196.801
DC$213.521
DE$181.731
FL$177.52–$192.803
GA$166.78–$186.662
GU$204.871
HI$204.871
IA$169.131
ID$170.051
IL$170.76–$189.464
IN$171.191
KS$167.551
KY$165.841
LA$165.27–$174.512
MA$192.19–$215.412
MD$185.71–$213.523
ME$170.30–$181.652
MI$170.03–$179.262
MN$187.161
MO$161.63–$176.043
MS$161.081
MT$183.701
NC$172.411
ND$182.711
NE$170.371
NH$190.041
NJ$199.45–$210.772
NM$170.791
NV$183.591
NY$175.23–$216.745
OH$169.831
OK$166.251
OR$182.57–$201.362
PA$170.52–$190.982
PR$185.441
RI$189.221
SC$171.321
SD$182.601
TN$168.401
TX$169.22–$192.828
UT$173.961
VA$180.50–$213.522
VI$185.441
VT$181.281
WA$192.06–$220.762
WI$175.841
WV$163.511
WY$183.271

How the 78261 rate is calculated

Each of 78261’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 · 78261

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.67

0.67 RVUs× 1.000 GPCI

Practice expense4.78

4.78 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

5.5000

Conversion factor

$33.4009

Medicare rate

$183.70

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 78261

The CMS indicators that decide how 78261 is paid alongside other services.

CMS payment indicators · 78261

Gastric mucosa scan, ectopic tissue localization

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

78261 without 26 · national office

$183.70

Gastric mucosa scan, ectopic tissue localization

78261-26 · Professional component

$26.72

Pays only the interpretation and report.

When to use modifier 26

78261 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78261

    Gastric mucosa scan, ectopic tissue localization0.67 wRVU

    $183.70

  • 78262

    Reflux imaging, gastroesophageal reflux0.66 wRVU

    $217.44+$33.74

  • 78264

    Gastric emptying, stomach only0.77 wRVU

    $289.92+$106.22

  • 78290

    Intestinal imaging, ectopic gastric mucosa0.66 wRVU

    $290.92+$107.22

How to choose

78262Reflux imagingGastroesophageal reflux
Use 78262 for imaging directed at gastroesophageal reflux; 78261 evaluates for functioning gastric-type tissue outside the stomach.
78264Gastric emptyingStomach only
78264 evaluates gastric emptying. It does not substitute for a study intended to localize ectopic gastric mucosa.
78290Intestinal imagingEctopic gastric mucosa
78290 is for intestine imaging. Choose 78261 when the target is ectopic functioning gastric mucosa rather than intestinal imaging generally.

78261 billing questions

When should 78261 be chosen over 78264?

Use 78261 to localize functioning gastric-type mucosa outside the stomach, such as in a suspected Meckel diverticulum. Use 78264 when the clinical question is how quickly the stomach empties.

How does 78261 differ from 78262?

78261 evaluates for ectopic gastric mucosa. 78262 is directed at gastroesophageal reflux.

How are the professional and technical services reported?

Report modifier 26 for the physician's interpretation or TC for the technical service. Billing without either modifier represents the global service.

What documentation supports reporting 78261?

Document the reason for evaluating ectopic gastric mucosa and the study findings, including the interpreting physician's conclusion about localization.

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 78261PPRRVU2026_Oct_nonQPP.csv, line 9,287 (RVU26D)

Open CMS sourceHow we calculate rates

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