CPT code 78261: Gastric mucosa scan, ectopic tissue localization2026 Medicare rate & RVUs in North Carolina
Nuclear medicine imaging to locate functioning gastric-type tissue outside the stomach, commonly ordered when a Meckel diverticulum is suspected.
In North Carolina, Medicare pays $172.41 for 78261 in the office.
Check a contract rate as a % of Medicare · 78261 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 10 sections
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.
How North Carolina compares for 78261
Across 109 of 109 payment localities, the office rate for 78261 runs from $160.38 in Arkansas to $255.96 in San Benito County, CA. North Carolina pays $172.41. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$172.41
- Los Angeles, CA · California$213.28+$40.87
- Washington, DC area · District of Columbia$213.52+$41.11
- Miami, FL · Florida$192.80+$20.39
- Chicago, IL · Illinois$186.82+$14.41
- Manhattan, NY · New York$211.98+$39.57
- Alaska · Alaska$204.52+$32.11
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $163.02 | — |
| ArkansasArkansas | $160.38 | — |
| ArizonaArizona | $178.52 | — |
| Bakersfield, CACalifornia | $198.80 | — |
| Chico, CACalifornia | $198.64 | — |
| El Centro, CACalifornia | $198.65 | — |
| Fresno, CACalifornia | $198.64 | — |
| Hanford, CACalifornia | $198.64 | — |
| Madera, CACalifornia | $198.64 | — |
| Merced, CACalifornia | $198.64 | — |
| Modesto, CACalifornia | $198.64 | — |
| Napa, CACalifornia | $235.06 | — |
| Oxnard, CACalifornia | $212.76 | — |
| Redding, CACalifornia | $198.64 | — |
| Rest of CaliforniaCalifornia | $198.64 | — |
| Riverside, CACalifornia | $199.19 | — |
| Sacramento, CACalifornia | $209.76 | — |
| Salinas, CACalifornia | $209.01 | — |
| San Diego, CACalifornia | $214.90 | — |
| Marin County, CACalifornia | $250.39 | — |
| San Francisco, CACalifornia | $250.33 | — |
| San Benito County, CACalifornia | $255.96 | — |
| Santa Clara County, CACalifornia | $255.73 | — |
| San Luis Obispo, CACalifornia | $205.50 | — |
| Santa Cruz, CACalifornia | $217.73 | — |
| Santa Maria, CACalifornia | $210.06 | — |
| Santa Rosa, CACalifornia | $220.00 | — |
| Stockton, CACalifornia | $198.64 | — |
| Vallejo, CACalifornia | $234.98 | — |
| Visalia, CACalifornia | $198.64 | — |
| Yuba City, CACalifornia | $198.64 | — |
| ColoradoColorado | $193.83 | — |
| ConnecticutConnecticut | $196.80 | — |
| DelawareDelaware | $181.73 | — |
| Fort Lauderdale, FLFlorida | $187.13 | — |
| Rest of FloridaFlorida | $177.52 | — |
| Atlanta, GAGeorgia | $186.66 | — |
| Rest of GeorgiaGeorgia | $166.78 | — |
| Hawaii, Guam, HIHawaii | $204.87 | — |
| IowaIowa | $169.13 | — |
| IdahoIdaho | $170.05 | — |
| East St. Louis, ILIllinois | $172.63 | — |
| Rest of IllinoisIllinois | $170.76 | — |
| Suburban Chicago, ILIllinois | $189.46 | — |
| IndianaIndiana | $171.19 | — |
| KansasKansas | $167.55 | — |
| KentuckyKentucky | $165.84 | — |
| New Orleans, LALouisiana | $174.51 | — |
| Rest of LouisianaLouisiana | $165.27 | — |
| Metropolitan Boston, MAMassachusetts | $215.41 | — |
| Rest of MassachusettsMassachusetts | $192.19 | — |
| Baltimore area, MDMaryland | $196.11 | — |
| Rest of MarylandMaryland | $185.71 | — |
| Rest of MaineMaine | $170.30 | — |
| Southern Maine, MEMaine | $181.65 | — |
| Detroit, MIMichigan | $179.26 | — |
| Rest of MichiganMichigan | $170.03 | — |
| MinnesotaMinnesota | $187.16 | — |
| Metropolitan Kansas City, MOMissouri | $173.93 | — |
| Metropolitan St. Louis, MOMissouri | $176.04 | — |
| Rest of MissouriMissouri | $161.63 | — |
| MississippiMississippi | $161.08 | — |
| MontanaMontana | $183.70 | — |
| North DakotaNorth Dakota | $182.71 | — |
| NebraskaNebraska | $170.37 | — |
| New HampshireNew Hampshire | $190.04 | — |
| Northern New JerseyNew Jersey | $210.77 | — |
| Rest of New JerseyNew Jersey | $199.45 | — |
| New MexicoNew Mexico | $170.79 | — |
| NevadaNevada | $183.59 | — |
| NYC suburbs and Long Island, NYNew York | $216.74 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $200.23 | — |
| Queens, NYNew York | $214.93 | — |
| Rest of New YorkNew York | $175.23 | — |
| OhioOhio | $169.83 | — |
| OklahomaOklahoma | $166.25 | — |
| Portland, OROregon | $201.36 | — |
| Rest of OregonOregon | $182.57 | — |
| Metropolitan Philadelphia, PAPennsylvania | $190.98 | — |
| Rest of PennsylvaniaPennsylvania | $170.52 | — |
| Puerto RicoPuerto Rico | $185.44 | — |
| Rhode IslandRhode Island | $189.22 | — |
| South CarolinaSouth Carolina | $171.32 | — |
| South DakotaSouth Dakota | $182.60 | — |
| TennesseeTennessee | $168.40 | — |
| Austin, TXTexas | $192.82 | — |
| Beaumont, TXTexas | $169.22 | — |
| Brazoria, TXTexas | $182.08 | — |
| Dallas, TXTexas | $183.03 | — |
| Fort Worth, TXTexas | $181.46 | — |
| Galveston, TXTexas | $182.48 | — |
| Houston, TXTexas | $183.39 | — |
| Rest of TexasTexas | $175.40 | — |
| UtahUtah | $173.96 | — |
| VirginiaVirginia | $180.50 | — |
| Virgin Islands, VIUnited States Virgin Islands | $185.44 | — |
| VermontVermont | $181.28 | — |
| Rest of WashingtonWashington | $192.06 | — |
| King County, WAWashington | $220.76 | — |
| WisconsinWisconsin | $175.84 | — |
| West VirginiaWest Virginia | $163.51 | — |
| WyomingWyoming | $183.27 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $204.52 | 1 |
| AL | $163.02 | 1 |
| AR | $160.38 | 1 |
| AZ | $178.52 | 1 |
| CA | $198.64–$255.96 | 29 |
| CO | $193.83 | 1 |
| CT | $196.80 | 1 |
| DC | $213.52 | 1 |
| DE | $181.73 | 1 |
| FL | $177.52–$192.80 | 3 |
| GA | $166.78–$186.66 | 2 |
| GU | $204.87 | 1 |
| HI | $204.87 | 1 |
| IA | $169.13 | 1 |
| ID | $170.05 | 1 |
| IL | $170.76–$189.46 | 4 |
| IN | $171.19 | 1 |
| KS | $167.55 | 1 |
| KY | $165.84 | 1 |
| LA | $165.27–$174.51 | 2 |
| MA | $192.19–$215.41 | 2 |
| MD | $185.71–$213.52 | 3 |
| ME | $170.30–$181.65 | 2 |
| MI | $170.03–$179.26 | 2 |
| MN | $187.16 | 1 |
| MO | $161.63–$176.04 | 3 |
| MS | $161.08 | 1 |
| MT | $183.70 | 1 |
| NC | $172.41 | 1 |
| ND | $182.71 | 1 |
| NE | $170.37 | 1 |
| NH | $190.04 | 1 |
| NJ | $199.45–$210.77 | 2 |
| NM | $170.79 | 1 |
| NV | $183.59 | 1 |
| NY | $175.23–$216.74 | 5 |
| OH | $169.83 | 1 |
| OK | $166.25 | 1 |
| OR | $182.57–$201.36 | 2 |
| PA | $170.52–$190.98 | 2 |
| PR | $185.44 | 1 |
| RI | $189.22 | 1 |
| SC | $171.32 | 1 |
| SD | $182.60 | 1 |
| TN | $168.40 | 1 |
| TX | $169.22–$192.82 | 8 |
| UT | $173.96 | 1 |
| VA | $180.50–$213.52 | 2 |
| VI | $185.44 | 1 |
| VT | $181.28 | 1 |
| WA | $192.06–$220.76 | 2 |
| WI | $175.84 | 1 |
| WV | $163.51 | 1 |
| WY | $183.27 | 1 |
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
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.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,287
- Code
- 78261
- Physician work
- 0.67
- Practice expense
- 4.78
- Malpractice
- 0.05
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.67 | × 1.000 | 0.6700 |
| Practice expense | 4.78 | × 0.933 | 4.4597 |
| Malpractice | 0.05 | × 0.639 | 0.0319 |
| Total RVUs | 5.1617 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$172.41
Office: (0.67 × 1 + 4.78 × 0.933 + 0.05 × 0.639) × $33.4009 = $172.41
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
| 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
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.
How 78261 has changed in North Carolina
78261 · Office / nonfacility
$172.41
Effective 2026-10-01
The base rate is $8.24 higher than on 2025-10-01, moving from $164.17 to $172.41 (5.0%).
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
$164.17changed to$172.41
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.69 changed to 0.67
- Practice expense RVU 4.70 changed to 4.78
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$171.94changed to$164.17
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.79 changed to 4.70
- Malpractice RVU 0.06 changed to 0.05
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$169.14changed to$171.94
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$178.25changed to$169.14
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.89 changed to 4.79
- Malpractice RVU 0.05 changed to 0.06
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$188.44changed to$178.25
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.08 changed to 4.89
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$196.80changed to$188.44
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.29 changed to 5.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$197.38changed to$196.80
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 5.09 changed to 5.29
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$196.99changed to$197.38
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 5.10 changed to 5.09
- Malpractice RVU 0.04 changed to 0.06
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$199.45changed to$196.99
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 5.18 changed to 5.10
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$241.18changed to$199.45
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 6.43 changed to 5.18
- Malpractice RVU 0.06 changed to 0.04
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$242.40changed to$241.18
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.48 changed to 6.43
- Malpractice RVU 0.07 changed to 0.06
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$246.62changed to$242.40
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.58 changed to 6.48
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$245.39changed to$246.62
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$241.21changed to$245.39
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.45 changed to 6.58
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$242.44changed to$241.21
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.89 changed to 6.45
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $242.44
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $172.41 | Not available in this setting | RVU26D |
| 2026-07-01 | $172.41 | Not available in this setting | RVU26C |
| 2026-04-01 | $172.41 | Not available in this setting | RVU26B |
| 2026-01-01 | $172.41 | Not available in this setting | RVU26A |
| 2025-10-01 | $164.17 | Not available in this setting | RVU25D |
| 2025-07-01 | $164.17 | Not available in this setting | RVU25C |
| 2025-04-01 | $164.17 | Not available in this setting | RVU25B |
| 2025-01-01 | $164.17 | Not available in this setting | RVU25A |
| 2024-10-01 | $171.94 | Not available in this setting | RVU24D |
| 2024-07-01 | $171.94 | Not available in this setting | RVU24C |
| 2024-04-01 | $171.94 | Not available in this setting | RVU24B |
| 2024-03-09 | $171.94 | Not available in this setting | RVU24AR |
| 2024-01-01 | $169.14 | Not available in this setting | RVU24A |
| 2023-10-01 | $178.25 | Not available in this setting | RVU23D |
| 2023-07-01 | $178.25 | Not available in this setting | RVU23C |
| 2023-04-01 | $178.25 | Not available in this setting | RVU23B |
| 2023-01-01 | $178.25 | Not available in this setting | RVU23A |
| 2022-10-01 | $188.44 | Not available in this setting | RVU22D |
| 2022-07-01 | $188.44 | Not available in this setting | RVU22C |
| 2022-04-01 | $188.44 | Not available in this setting | RVU22B |
| 2022-01-01 | $188.44 | Not available in this setting | RVU22A |
| 2021-10-01 | $196.80 | Not available in this setting | RVU21D |
| 2021-07-01 | $196.80 | Not available in this setting | RVU21C |
| 2021-04-01 | $196.80 | Not available in this setting | RVU21B |
| 2021-01-01 | $196.80 | Not available in this setting | RVU21A |
| 2020-10-01 | $197.38 | Not available in this setting | RVU20D |
| 2020-07-01 | $197.38 | Not available in this setting | RVU20C |
| 2020-04-01 | $197.38 | Not available in this setting | RVU20B |
| 2020-01-01 | $197.38 | Not available in this setting | RVU20A |
| 2019-10-01 | $196.99 | Not available in this setting | RVU19D |
| 2019-07-01 | $196.99 | Not available in this setting | RVU19C |
| 2019-04-01 | $196.99 | Not available in this setting | RVU19B |
| 2019-01-01 | $196.99 | Not available in this setting | RVU19A |
| 2018-10-01 | $199.45 | Not available in this setting | RVU18D |
| 2018-07-01 | $199.45 | Not available in this setting | RVU18C |
| 2018-04-01 | $199.45 | Not available in this setting | RVU18B |
| 2018-01-01 | $199.45 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $241.18 | Not available in this setting | RVU17D |
| 2017-07-01 | $241.18 | Not available in this setting | RVU17C |
| 2017-04-01 | $241.18 | Not available in this setting | RVU17B |
| 2017-01-01 | $241.18 | Not available in this setting | RVU17A |
| 2016-10-01 | $242.40 | Not available in this setting | RVU16D |
| 2016-07-01 | $242.40 | Not available in this setting | RVU16C |
| 2016-04-01 | $242.40 | Not available in this setting | RVU16B |
| 2016-01-01 | $242.40 | Not available in this setting | RVU16A |
| 2015-10-01 | $246.62 | Not available in this setting | RVU15D |
| 2015-07-01 | $246.62 | Not available in this setting | RVU15C |
| 2015-04-01 | $245.39 | Not available in this setting | RVU15B |
| 2015-01-01 | $245.39 | Not available in this setting | RVU15A |
| 2014-10-01 | $241.21 | Not available in this setting | RVU14D |
| 2014-07-01 | $241.21 | Not available in this setting | RVU14C |
| 2014-04-01 | $241.21 | Not available in this setting | RVU14B |
| 2014-01-01 | $241.21 | Not available in this setting | RVU14A |
| 2013-10-01 | $242.44 | Not available in this setting | RVU13D |
| 2013-07-01 | $242.44 | Not available in this setting | RVU13C |
| 2013-04-01 | $242.44 | Not available in this setting | RVU13B |
| 2013-01-01 | $242.44 | Not available in this setting | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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
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