CPT code 78264: Gastric emptying, stomach only2026 Medicare rate & RVUs in Louisiana

Reports scintigraphic assessment of how quickly a radiolabeled meal leaves the stomach, commonly when symptoms raise concern for delayed gastric emptying.

CMS RVU26DEffective Oct 1, 20262 payment localities48.4K Medicare services in 2024

Medicare pays $259.76–$274.92 for 78264 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. Which amount applies depends on the service address.

$259.76–$274.92Office (non-facility)
—Hospital or facility

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. Rate in Louisiana
  2. What 78264 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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 in Louisiana

78264 office and facility rates by payment locality
Payment localityOfficeFacility
New Orleans, LA$274.92Unavailable
Rest of Louisiana$259.76Unavailable

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

Office or facility?

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

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

78264 without 26 · national office

$289.92

Gastric emptying, stomach only

78264-26 · Professional component

$35.74

Pays only the interpretation and report.

When to use modifier 26

78264 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78264

    Gastric emptying, stomach only0.77 wRVU

    $289.92

  • 78265

    Gastric emptying, with small bowel transit0.96 wRVU

    $347.70+$57.78

  • 78266

    GI transit imaging, small bowel and colon transit1.05 wRVU

    $394.80+$104.88

  • 78262

    Reflux imaging, gastroesophageal reflux0.66 wRVU

    $217.44−$72.48

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

Show the CMS file lines behind this rate
RVUs for 78264PPRRVU2026_Oct_nonQPP.csv, line 9,293 (RVU26D)

Open CMS sourceHow we calculate rates

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