CPT code 78264: Gastric emptying, stomach only2026 Medicare rate & RVUs
Reports scintigraphic assessment of how quickly a radiolabeled meal leaves the stomach, commonly when symptoms raise concern for delayed gastric emptying.
Medicare pays $289.92 for 78264 nationally in the office. Local office rates run $251.63–$406.80.
Medicare rate · 78264
Gastric emptying, stomach only
- Work RVUs
- 0.77
- Total RVUs
- 8.68
- Global days
- XXX
National rate · 2026
$289.92
Office setting, before claim adjustments.
See every locality for 78264 →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.
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On this page 10 sections
What 78264 covers
A nuclear medicine team administers a radiolabeled meal and obtains serial images to track its passage out of the stomach. The study is commonly ordered for patients with nausea, vomiting, early satiety, or post-meal fullness when delayed gastric emptying is being evaluated. A nuclear medicine physician interprets the images; a technologist typically prepares the imaging equipment and acquires the study in a hospital or outpatient imaging department.
Report 78264 for the gastric-emptying assessment itself, rather than an examination that also evaluates transit through the small bowel or colon. The record should identify the meal or protocol used, document image acquisition, and include the physician’s interpretation of gastric emptying. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and an unmodified claim 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 78264 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
$251.63 to $406.80
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $255.97 | Unavailable |
| Alaska | $318.41 | Unavailable |
| Arizona | $281.39 | Unavailable |
| Arkansas | $251.63 | Unavailable |
| Atlanta, GA | $294.78 | Unavailable |
| Austin, TX | $304.78 | Unavailable |
| Bakersfield, CA | $314.31 | Unavailable |
| Baltimore area, MD | $310.11 | Unavailable |
| Beaumont, TX | $266.20 | Unavailable |
| Brazoria, TX | $287.11 | Unavailable |
| Chicago, IL | $295.30 | Unavailable |
| Chico, CA | $314.04 | Unavailable |
| Colorado | $306.29 | Unavailable |
| Connecticut | $311.18 | Unavailable |
| Dallas, TX | $288.68 | Unavailable |
| Delaware | $286.61 | Unavailable |
| Detroit, MI | $282.84 | Unavailable |
| East St. Louis, IL | $272.07 | Unavailable |
| El Centro, CA | $314.05 | Unavailable |
| Fort Lauderdale, FL | $295.74 | Unavailable |
| Fort Worth, TX | $286.11 | Unavailable |
| Fresno, CA | $314.04 | Unavailable |
| Galveston, TX | $287.78 | Unavailable |
| Hanford, CA | $314.04 | Unavailable |
| Hawaii, Guam, HI | $324.44 | Unavailable |
| Houston, TX | $289.43 | Unavailable |
| Idaho | $267.44 | Unavailable |
| Indiana | $269.31 | Unavailable |
| Iowa | $265.91 | Unavailable |
| Kansas | $263.35 | Unavailable |
| Kentucky | $260.67 | Unavailable |
| King County, WA | $349.95 | Unavailable |
| Los Angeles, CA | $337.76 | Unavailable |
| Madera, CA | $314.04 | Unavailable |
| Manhattan, NY | $335.64 | Unavailable |
| Marin County, CA | $397.83 | Unavailable |
| Merced, CA | $314.04 | Unavailable |
| Metropolitan Boston, MA | $341.32 | Unavailable |
| Metropolitan Kansas City, MO | $273.92 | Unavailable |
| Metropolitan Philadelphia, PA | $301.67 | Unavailable |
| Metropolitan St. Louis, MO | $277.39 | Unavailable |
| Miami, FL | $305.23 | Unavailable |
| Minnesota | $295.38 | Unavailable |
| Mississippi | $252.83 | Unavailable |
| Modesto, CA | $314.04 | Unavailable |
| Montana | $289.91 | Unavailable |
| Napa, CA | $373.12 | Unavailable |
| Nebraska | $267.94 | Unavailable |
| Nevada | $289.68 | Unavailable |
| New Hampshire | $300.25 | Unavailable |
| New Mexico | $268.84 | Unavailable |
| New Orleans, LA | $274.92 | Unavailable |
| North Carolina | $271.33 | Unavailable |
| North Dakota | $288.13 | Unavailable |
| Northern New Jersey | $333.54 | Unavailable |
| NYC suburbs and Long Island, NY | $343.51 | Unavailable |
| Ohio | $267.22 | Unavailable |
| Oklahoma | $261.30 | Unavailable |
| Oxnard, CA | $337.04 | Unavailable |
| Portland, OR | $318.55 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $316.52 | Unavailable |
| Puerto Rico | $292.75 | Unavailable |
| Queens, NY | $340.43 | Unavailable |
| Redding, CA | $314.04 | Unavailable |
| Rest of California | $314.04 | Unavailable |
| Rest of Florida | $279.94 | Unavailable |
| Rest of Georgia | $262.29 | Unavailable |
| Rest of Illinois | $268.89 | Unavailable |
| Rest of Louisiana | $259.76 | Unavailable |
| Rest of Maine | $267.89 | Unavailable |
| Rest of Maryland | $293.06 | Unavailable |
| Rest of Massachusetts | $303.56 | Unavailable |
| Rest of Michigan | $267.58 | Unavailable |
| Rest of Missouri | $253.80 | Unavailable |
| Rest of New Jersey | $315.27 | Unavailable |
| Rest of New York | $275.97 | Unavailable |
| Rest of Oregon | $287.98 | Unavailable |
| Rest of Pennsylvania | $268.34 | Unavailable |
| Rest of Texas | $276.31 | Unavailable |
| Rest of Washington | $303.38 | Unavailable |
| Rhode Island | $298.70 | Unavailable |
| Riverside, CA | $315.02 | Unavailable |
| Sacramento, CA | $332.03 | Unavailable |
| Salinas, CA | $330.85 | Unavailable |
| San Benito County, CA | $406.80 | Unavailable |
| San Diego, CA | $340.51 | Unavailable |
| San Francisco, CA | $397.72 | Unavailable |
| San Luis Obispo, CA | $325.27 | Unavailable |
| Santa Clara County, CA | $406.38 | Unavailable |
| Santa Cruz, CA | $345.22 | Unavailable |
| Santa Maria, CA | $332.60 | Unavailable |
| Santa Rosa, CA | $348.85 | Unavailable |
| South Carolina | $269.62 | Unavailable |
| South Dakota | $287.92 | Unavailable |
| Southern Maine, ME | $286.46 | Unavailable |
| Stockton, CA | $314.04 | Unavailable |
| Suburban Chicago, IL | $299.47 | Unavailable |
| Tennessee | $264.76 | Unavailable |
| Utah | $273.94 | Unavailable |
| Vallejo, CA | $372.97 | Unavailable |
| Vermont | $285.82 | Unavailable |
| Virgin Islands, VI | $292.75 | Unavailable |
| Virginia | $284.60 | Unavailable |
| Visalia, CA | $314.04 | Unavailable |
| Washington, DC area | $338.14 | Unavailable |
| West Virginia | $257.00 | Unavailable |
| Wisconsin | $276.87 | Unavailable |
| Wyoming | $289.14 | Unavailable |
| Yuba City, CA | $314.04 | Unavailable |
78264 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.
$251.63
$360.42
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 | $318.41 | 1 |
| AL | $255.97 | 1 |
| AR | $251.63 | 1 |
| AZ | $281.39 | 1 |
| CA | $314.04–$406.80 | 29 |
| CO | $306.29 | 1 |
| CT | $311.18 | 1 |
| DC | $338.14 | 1 |
| DE | $286.61 | 1 |
| FL | $279.94–$305.23 | 3 |
| GA | $262.29–$294.78 | 2 |
| GU | $324.44 | 1 |
| HI | $324.44 | 1 |
| IA | $265.91 | 1 |
| ID | $267.44 | 1 |
| IL | $268.89–$299.47 | 4 |
| IN | $269.31 | 1 |
| KS | $263.35 | 1 |
| KY | $260.67 | 1 |
| LA | $259.76–$274.92 | 2 |
| MA | $303.56–$341.32 | 2 |
| MD | $293.06–$338.14 | 3 |
| ME | $267.89–$286.46 | 2 |
| MI | $267.58–$282.84 | 2 |
| MN | $295.38 | 1 |
| MO | $253.80–$277.39 | 3 |
| MS | $252.83 | 1 |
| MT | $289.91 | 1 |
| NC | $271.33 | 1 |
| ND | $288.13 | 1 |
| NE | $267.94 | 1 |
| NH | $300.25 | 1 |
| NJ | $315.27–$333.54 | 2 |
| NM | $268.84 | 1 |
| NV | $289.68 | 1 |
| NY | $275.97–$343.51 | 5 |
| OH | $267.22 | 1 |
| OK | $261.30 | 1 |
| OR | $287.98–$318.55 | 2 |
| PA | $268.34–$301.67 | 2 |
| PR | $292.75 | 1 |
| RI | $298.70 | 1 |
| SC | $269.62 | 1 |
| SD | $287.92 | 1 |
| TN | $264.76 | 1 |
| TX | $266.20–$304.78 | 8 |
| UT | $273.94 | 1 |
| VA | $284.60–$338.14 | 2 |
| VI | $292.75 | 1 |
| VT | $285.82 | 1 |
| WA | $303.38–$349.95 | 2 |
| WI | $276.87 | 1 |
| WV | $257.00 | 1 |
| WY | $289.14 | 1 |
How the 78264 rate is calculated
Each of 78264’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 · 78264
RVUs × geographic indexes × conversion factor
Work0.77
0.77 RVUs× 1.000 GPCI
Practice expense7.82
7.82 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
8.6800
Conversion factor
$33.4009
Medicare rate
$289.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78264
The CMS indicators that decide how 78264 is paid alongside other services.
CMS payment indicators · 78264
Gastric emptying, stomach only
| 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
78264 without 26 · national office
$289.92
Gastric emptying, stomach only
78264-26 · Professional component
$35.74
Pays only the interpretation and report.
78264 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78265Gastric emptyingWith small bowel transit
- 78264 assesses gastric emptying alone; 78265 includes assessment of small-bowel transit as well.
- 78266GI transit imagingSmall bowel and colon transit
- 78266 extends the transit assessment through the small bowel and colon, beyond the stomach-only focus of 78264.
- 78262Reflux imagingGastroesophageal reflux
- 78262 evaluates gastroesophageal reflux. Choose 78264 when the question is how quickly the stomach empties.
78264 billing questions
When should 78264 be chosen over 78265?
Use 78264 when the study assesses gastric emptying alone. Choose 78265 when the examination also evaluates small-bowel transit.
How should the professional and technical services be reported?
Append modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff portion. Report the global service without either modifier.
What documentation supports this code?
Document the gastric-emptying protocol and meal, image acquisition, and the interpreting physician’s findings. The report should make clear that the examination evaluates stomach emptying rather than downstream transit.
Can this code be used when small-bowel or colon transit is also assessed?
Use the code that reflects the full study performed: 78265 includes small-bowel transit, and 78266 includes small-bowel and colon transit with gastric emptying.
Does 78264 represent a single image or the gastric-emptying examination?
It represents the gastric-emptying imaging study, which uses serial images to assess passage of the meal from the stomach.
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
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