CPT code 78264: Gastric emptying, stomach only2026 Medicare rate & RVUs in South Dakota
Reports scintigraphic assessment of how quickly a radiolabeled meal leaves the stomach, commonly when symptoms raise concern for delayed gastric emptying.
In South Dakota, Medicare pays $287.92 for 78264 in the office.
Check a contract rate as a % of Medicare · 78264 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 11 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.
How South Dakota compares for 78264
Across 109 of 109 payment localities, the office rate for 78264 runs from $251.63 in Arkansas to $406.80 in San Benito County, CA. South Dakota pays $287.92. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$287.92
- Los Angeles, CA · California$337.76+$49.84
- Washington, DC area · District of Columbia$338.14+$50.22
- Miami, FL · Florida$305.23+$17.31
- Chicago, IL · Illinois$295.30+$7.38
- Manhattan, NY · New York$335.64+$47.72
- Alaska · Alaska$318.41+$30.49
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $255.97 | — |
| ArkansasArkansas | $251.63 | — |
| ArizonaArizona | $281.39 | — |
| Bakersfield, CACalifornia | $314.31 | — |
| Chico, CACalifornia | $314.04 | — |
| El Centro, CACalifornia | $314.05 | — |
| Fresno, CACalifornia | $314.04 | — |
| Hanford, CACalifornia | $314.04 | — |
| Madera, CACalifornia | $314.04 | — |
| Merced, CACalifornia | $314.04 | — |
| Modesto, CACalifornia | $314.04 | — |
| Napa, CACalifornia | $373.12 | — |
| Oxnard, CACalifornia | $337.04 | — |
| Redding, CACalifornia | $314.04 | — |
| Rest of CaliforniaCalifornia | $314.04 | — |
| Riverside, CACalifornia | $315.02 | — |
| Sacramento, CACalifornia | $332.03 | — |
| Salinas, CACalifornia | $330.85 | — |
| San Diego, CACalifornia | $340.51 | — |
| Marin County, CACalifornia | $397.83 | — |
| San Francisco, CACalifornia | $397.72 | — |
| San Benito County, CACalifornia | $406.80 | — |
| Santa Clara County, CACalifornia | $406.38 | — |
| San Luis Obispo, CACalifornia | $325.27 | — |
| Santa Cruz, CACalifornia | $345.22 | — |
| Santa Maria, CACalifornia | $332.60 | — |
| Santa Rosa, CACalifornia | $348.85 | — |
| Stockton, CACalifornia | $314.04 | — |
| Vallejo, CACalifornia | $372.97 | — |
| Visalia, CACalifornia | $314.04 | — |
| Yuba City, CACalifornia | $314.04 | — |
| ColoradoColorado | $306.29 | — |
| ConnecticutConnecticut | $311.18 | — |
| DelawareDelaware | $286.61 | — |
| Fort Lauderdale, FLFlorida | $295.74 | — |
| Rest of FloridaFlorida | $279.94 | — |
| Atlanta, GAGeorgia | $294.78 | — |
| Rest of GeorgiaGeorgia | $262.29 | — |
| Hawaii, Guam, HIHawaii | $324.44 | — |
| IowaIowa | $265.91 | — |
| IdahoIdaho | $267.44 | — |
| East St. Louis, ILIllinois | $272.07 | — |
| Rest of IllinoisIllinois | $268.89 | — |
| Suburban Chicago, ILIllinois | $299.47 | — |
| IndianaIndiana | $269.31 | — |
| KansasKansas | $263.35 | — |
| KentuckyKentucky | $260.67 | — |
| New Orleans, LALouisiana | $274.92 | — |
| Rest of LouisianaLouisiana | $259.76 | — |
| Metropolitan Boston, MAMassachusetts | $341.32 | — |
| Rest of MassachusettsMassachusetts | $303.56 | — |
| Baltimore area, MDMaryland | $310.11 | — |
| Rest of MarylandMaryland | $293.06 | — |
| Rest of MaineMaine | $267.89 | — |
| Southern Maine, MEMaine | $286.46 | — |
| Detroit, MIMichigan | $282.84 | — |
| Rest of MichiganMichigan | $267.58 | — |
| MinnesotaMinnesota | $295.38 | — |
| Metropolitan Kansas City, MOMissouri | $273.92 | — |
| Metropolitan St. Louis, MOMissouri | $277.39 | — |
| Rest of MissouriMissouri | $253.80 | — |
| MississippiMississippi | $252.83 | — |
| MontanaMontana | $289.91 | — |
| North CarolinaNorth Carolina | $271.33 | — |
| North DakotaNorth Dakota | $288.13 | — |
| NebraskaNebraska | $267.94 | — |
| New HampshireNew Hampshire | $300.25 | — |
| Northern New JerseyNew Jersey | $333.54 | — |
| Rest of New JerseyNew Jersey | $315.27 | — |
| New MexicoNew Mexico | $268.84 | — |
| NevadaNevada | $289.68 | — |
| NYC suburbs and Long Island, NYNew York | $343.51 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $316.52 | — |
| Queens, NYNew York | $340.43 | — |
| Rest of New YorkNew York | $275.97 | — |
| OhioOhio | $267.22 | — |
| OklahomaOklahoma | $261.30 | — |
| Portland, OROregon | $318.55 | — |
| Rest of OregonOregon | $287.98 | — |
| Metropolitan Philadelphia, PAPennsylvania | $301.67 | — |
| Rest of PennsylvaniaPennsylvania | $268.34 | — |
| Puerto RicoPuerto Rico | $292.75 | — |
| Rhode IslandRhode Island | $298.70 | — |
| South CarolinaSouth Carolina | $269.62 | — |
| TennesseeTennessee | $264.76 | — |
| Austin, TXTexas | $304.78 | — |
| Beaumont, TXTexas | $266.20 | — |
| Brazoria, TXTexas | $287.11 | — |
| Dallas, TXTexas | $288.68 | — |
| Fort Worth, TXTexas | $286.11 | — |
| Galveston, TXTexas | $287.78 | — |
| Houston, TXTexas | $289.43 | — |
| Rest of TexasTexas | $276.31 | — |
| UtahUtah | $273.94 | — |
| VirginiaVirginia | $284.60 | — |
| Virgin Islands, VIUnited States Virgin Islands | $292.75 | — |
| VermontVermont | $285.82 | — |
| Rest of WashingtonWashington | $303.38 | — |
| King County, WAWashington | $349.95 | — |
| WisconsinWisconsin | $276.87 | — |
| West VirginiaWest Virginia | $257.00 | — |
| WyomingWyoming | $289.14 | — |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,293
- Code
- 78264
- Physician work
- 0.77
- Practice expense
- 7.82
- Malpractice
- 0.09
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.77 | × 1.000 | 0.7700 |
| Practice expense | 7.82 | × 1.000 | 7.8200 |
| Malpractice | 0.09 | × 0.336 | 0.0302 |
| Total RVUs | 8.6202 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$287.92
Office: (0.77 × 1 + 7.82 × 1 + 0.09 × 0.336) × $33.4009 = $287.92
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.
How 78264 has changed in South Dakota
78264 · Office / nonfacility
$287.92
Effective 2026-10-01
The base rate is $2.48 higher than on 2025-10-01, moving from $285.44 to $287.92 (0.9%).
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
$285.44changed to$287.92
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.79 changed to 0.77
- Practice expense RVU 8.00 changed to 7.82
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$299.53changed to$285.44
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.17 changed to 8.00
- Malpractice RVU 0.10 changed to 0.09
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$294.64changed to$299.53
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$310.72changed to$294.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.35 changed to 8.17
- Malpractice RVU 0.08 changed to 0.10
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$321.88changed to$310.72
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.48 changed to 8.35
- Malpractice RVU 0.09 changed to 0.08
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$338.85changed to$321.88
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.89 changed to 8.48
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$341.75changed to$338.85
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.65 changed to 8.89
- Malpractice RVU 0.08 changed to 0.09
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$346.02changed to$341.75
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.78 changed to 8.65
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$352.84changed to$346.02
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.98 changed to 8.78
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$351.41changed to$352.84
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.97 changed to 8.98
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$347.37changed to$351.41
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 0.74 changed to 0.79
- Practice expense RVU 8.93 changed to 8.97
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$300.33changed to$347.37
- Conversion factor 35.9335 changed to 35.8043
- Work RVU 0.80 changed to 0.74
- Practice expense RVU 7.53 changed to 8.93
- Malpractice RVU 0.07 changed to 0.08
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$298.84changed to$300.33
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$292.64changed to$298.84
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 7.34 changed to 7.53
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$292.64
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $287.92 | Not available in this setting | RVU26D |
| 2026-07-01 | $287.92 | Not available in this setting | RVU26C |
| 2026-04-01 | $287.92 | Not available in this setting | RVU26B |
| 2026-01-01 | $287.92 | Not available in this setting | RVU26A |
| 2025-10-01 | $285.44 | Not available in this setting | RVU25D |
| 2025-07-01 | $285.44 | Not available in this setting | RVU25C |
| 2025-04-01 | $285.44 | Not available in this setting | RVU25B |
| 2025-01-01 | $285.44 | Not available in this setting | RVU25A |
| 2024-10-01 | $299.53 | Not available in this setting | RVU24D |
| 2024-07-01 | $299.53 | Not available in this setting | RVU24C |
| 2024-04-01 | $299.53 | Not available in this setting | RVU24B |
| 2024-03-09 | $299.53 | Not available in this setting | RVU24AR |
| 2024-01-01 | $294.64 | Not available in this setting | RVU24A |
| 2023-10-01 | $310.72 | Not available in this setting | RVU23D |
| 2023-07-01 | $310.72 | Not available in this setting | RVU23C |
| 2023-04-01 | $310.72 | Not available in this setting | RVU23B |
| 2023-01-01 | $310.72 | Not available in this setting | RVU23A |
| 2022-10-01 | $321.88 | Not available in this setting | RVU22D |
| 2022-07-01 | $321.88 | Not available in this setting | RVU22C |
| 2022-04-01 | $321.88 | Not available in this setting | RVU22B |
| 2022-01-01 | $321.88 | Not available in this setting | RVU22A |
| 2021-10-01 | $338.85 | Not available in this setting | RVU21D |
| 2021-07-01 | $338.85 | Not available in this setting | RVU21C |
| 2021-04-01 | $338.85 | Not available in this setting | RVU21B |
| 2021-01-01 | $338.85 | Not available in this setting | RVU21A |
| 2020-10-01 | $341.75 | Not available in this setting | RVU20D |
| 2020-07-01 | $341.75 | Not available in this setting | RVU20C |
| 2020-04-01 | $341.75 | Not available in this setting | RVU20B |
| 2020-01-01 | $341.75 | Not available in this setting | RVU20A |
| 2019-10-01 | $346.02 | Not available in this setting | RVU19D |
| 2019-07-01 | $346.02 | Not available in this setting | RVU19C |
| 2019-04-01 | $346.02 | Not available in this setting | RVU19B |
| 2019-01-01 | $346.02 | Not available in this setting | RVU19A |
| 2018-10-01 | $352.84 | Not available in this setting | RVU18D |
| 2018-07-01 | $352.84 | Not available in this setting | RVU18C |
| 2018-04-01 | $352.84 | Not available in this setting | RVU18B |
| 2018-01-01 | $352.84 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $351.41 | Not available in this setting | RVU17D |
| 2017-07-01 | $351.41 | Not available in this setting | RVU17C |
| 2017-04-01 | $351.41 | Not available in this setting | RVU17B |
| 2017-01-01 | $351.41 | Not available in this setting | RVU17A |
| 2016-10-01 | $347.37 | Not available in this setting | RVU16D |
| 2016-07-01 | $347.37 | Not available in this setting | RVU16C |
| 2016-04-01 | $347.37 | Not available in this setting | RVU16B |
| 2016-01-01 | $347.37 | Not available in this setting | RVU16A |
| 2015-10-01 | $300.33 | Not available in this setting | RVU15D |
| 2015-07-01 | $300.33 | Not available in this setting | RVU15C |
| 2015-04-01 | $298.84 | Not available in this setting | RVU15B |
| 2015-01-01 | $298.84 | Not available in this setting | RVU15A |
| 2014-10-01 | $292.64 | Not available in this setting | RVU14D |
| 2014-07-01 | $292.64 | Not available in this setting | RVU14C |
| 2014-04-01 | $292.64 | Not available in this setting | RVU14B |
| 2014-01-01 | $292.64 | Not available in this setting | RVU14A |
| 2013-10-01 | Additional calculation required | Not available in this setting | RVU13D |
| 2013-07-01 | Additional calculation required | Not available in this setting | RVU13C |
| 2013-04-01 | Additional calculation required | Not available in this setting | RVU13B |
| 2013-01-01 | Additional calculation required | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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