CPT code 78265: Gastric emptying, with small bowel transit2026 Medicare rate & RVUs in Vermont
Reports gastric emptying imaging that also tracks transit through the small bowel, providing assessment of gastric and small bowel movement.
In Vermont, Medicare pays $342.77 for 78265 in the office.
Check a contract rate as a % of Medicare · 78265 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 78265 covers
This nuclear medicine study follows a radiolabeled meal as it leaves the stomach and moves through the small bowel. A nuclear medicine technologist typically prepares or administers the tracer meal and obtains serial images; a nuclear medicine physician interprets the study. It is used when the clinical question includes both gastric emptying and small bowel transit, such as evaluation of delayed gastric emptying with downstream transit assessment.
Select this code when the imaging study includes small bowel transit, rather than gastric emptying alone or transit through both the small bowel and colon. The report should identify the study performed and document the imaging and interpretation. CMS recognizes separately billable professional and technical components: use modifier 26 for the interpretation, modifier TC for equipment and staff, or bill without a modifier for 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 Vermont compares for 78265
Across 109 of 109 payment localities, the office rate for 78265 runs from $301.93 in Arkansas to $487.41 in San Benito County, CA. Vermont pays $342.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$342.77
- Los Angeles, CA · California$404.87+$62.10
- Washington, DC area · District of Columbia$405.38+$62.61
- Miami, FL · Florida$366.11+$23.34
- Chicago, IL · Illinois$354.25+$11.48
- Manhattan, NY · New York$402.45+$59.68
- Alaska · Alaska$382.36+$39.59
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $307.11 | — |
| ArkansasArkansas | $301.93 | — |
| ArizonaArizona | $337.50 | — |
| Bakersfield, CACalifornia | $376.82 | — |
| Chico, CACalifornia | $376.49 | — |
| El Centro, CACalifornia | $376.51 | — |
| Fresno, CACalifornia | $376.49 | — |
| Hanford, CACalifornia | $376.49 | — |
| Madera, CACalifornia | $376.49 | — |
| Merced, CACalifornia | $376.49 | — |
| Modesto, CACalifornia | $376.49 | — |
| Napa, CACalifornia | $447.12 | — |
| Oxnard, CACalifornia | $403.99 | — |
| Redding, CACalifornia | $376.49 | — |
| Rest of CaliforniaCalifornia | $376.49 | — |
| Riverside, CACalifornia | $377.69 | — |
| Sacramento, CACalifornia | $398.00 | — |
| Salinas, CACalifornia | $396.59 | — |
| San Diego, CACalifornia | $408.13 | — |
| Marin County, CACalifornia | $476.67 | — |
| San Francisco, CACalifornia | $476.54 | — |
| San Benito County, CACalifornia | $487.41 | — |
| Santa Clara County, CACalifornia | $486.90 | — |
| San Luis Obispo, CACalifornia | $389.91 | — |
| Santa Cruz, CACalifornia | $413.74 | — |
| Santa Maria, CACalifornia | $398.68 | — |
| Santa Rosa, CACalifornia | $418.09 | — |
| Stockton, CACalifornia | $376.49 | — |
| Vallejo, CACalifornia | $446.94 | — |
| Visalia, CACalifornia | $376.49 | — |
| Yuba City, CACalifornia | $376.49 | — |
| ColoradoColorado | $367.25 | — |
| ConnecticutConnecticut | $373.14 | — |
| DelawareDelaware | $343.75 | — |
| Fort Lauderdale, FLFlorida | $354.73 | — |
| Rest of FloridaFlorida | $335.83 | — |
| Atlanta, GAGeorgia | $353.53 | — |
| Rest of GeorgiaGeorgia | $314.72 | — |
| Hawaii, Guam, HIHawaii | $388.90 | — |
| IowaIowa | $318.97 | — |
| IdahoIdaho | $320.81 | — |
| East St. Louis, ILIllinois | $326.47 | — |
| Rest of IllinoisIllinois | $322.63 | — |
| Suburban Chicago, ILIllinois | $359.19 | — |
| IndianaIndiana | $323.04 | — |
| KansasKansas | $315.93 | — |
| KentuckyKentucky | $312.76 | — |
| New Orleans, LALouisiana | $329.80 | — |
| Rest of LouisianaLouisiana | $311.67 | — |
| Metropolitan Boston, MAMassachusetts | $409.13 | — |
| Rest of MassachusettsMassachusetts | $364.00 | — |
| Baltimore area, MDMaryland | $371.86 | — |
| Rest of MarylandMaryland | $351.47 | — |
| Rest of MaineMaine | $321.36 | — |
| Southern Maine, MEMaine | $343.54 | — |
| Detroit, MIMichigan | $339.31 | — |
| Rest of MichiganMichigan | $321.04 | — |
| MinnesotaMinnesota | $354.16 | — |
| Metropolitan Kansas City, MOMissouri | $328.59 | — |
| Metropolitan St. Louis, MOMissouri | $332.74 | — |
| Rest of MissouriMissouri | $304.56 | — |
| MississippiMississippi | $303.38 | — |
| MontanaMontana | $347.70 | — |
| North CarolinaNorth Carolina | $325.48 | — |
| North DakotaNorth Dakota | $345.52 | — |
| NebraskaNebraska | $321.40 | — |
| New HampshireNew Hampshire | $360.03 | — |
| Northern New JerseyNew Jersey | $399.89 | — |
| Rest of New JerseyNew Jersey | $378.04 | — |
| New MexicoNew Mexico | $322.55 | — |
| NevadaNevada | $347.40 | — |
| NYC suburbs and Long Island, NYNew York | $411.87 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $379.55 | — |
| Queens, NYNew York | $408.16 | — |
| Rest of New YorkNew York | $331.01 | — |
| OhioOhio | $320.59 | — |
| OklahomaOklahoma | $313.50 | — |
| Portland, OROregon | $381.90 | — |
| Rest of OregonOregon | $345.36 | — |
| Metropolitan Philadelphia, PAPennsylvania | $361.78 | — |
| Rest of PennsylvaniaPennsylvania | $321.92 | — |
| Puerto RicoPuerto Rico | $351.08 | — |
| Rhode IslandRhode Island | $358.21 | — |
| South CarolinaSouth Carolina | $323.44 | — |
| South DakotaSouth Dakota | $345.26 | — |
| TennesseeTennessee | $317.61 | — |
| Austin, TXTexas | $365.44 | — |
| Beaumont, TXTexas | $319.37 | — |
| Brazoria, TXTexas | $344.34 | — |
| Dallas, TXTexas | $346.22 | — |
| Fort Worth, TXTexas | $343.15 | — |
| Galveston, TXTexas | $345.14 | — |
| Houston, TXTexas | $347.16 | — |
| Rest of TexasTexas | $331.44 | — |
| UtahUtah | $328.61 | — |
| VirginiaVirginia | $341.32 | — |
| Virgin Islands, VIUnited States Virgin Islands | $351.08 | — |
| Rest of WashingtonWashington | $363.78 | — |
| King County, WAWashington | $419.45 | — |
| WisconsinWisconsin | $332.06 | — |
| West VirginiaWest Virginia | $308.42 | — |
| WyomingWyoming | $346.75 | — |
78265 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.
$301.93
$431.95
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 | $382.36 | 1 |
| AL | $307.11 | 1 |
| AR | $301.93 | 1 |
| AZ | $337.50 | 1 |
| CA | $376.49–$487.41 | 29 |
| CO | $367.25 | 1 |
| CT | $373.14 | 1 |
| DC | $405.38 | 1 |
| DE | $343.75 | 1 |
| FL | $335.83–$366.11 | 3 |
| GA | $314.72–$353.53 | 2 |
| GU | $388.90 | 1 |
| HI | $388.90 | 1 |
| IA | $318.97 | 1 |
| ID | $320.81 | 1 |
| IL | $322.63–$359.19 | 4 |
| IN | $323.04 | 1 |
| KS | $315.93 | 1 |
| KY | $312.76 | 1 |
| LA | $311.67–$329.80 | 2 |
| MA | $364.00–$409.13 | 2 |
| MD | $351.47–$405.38 | 3 |
| ME | $321.36–$343.54 | 2 |
| MI | $321.04–$339.31 | 2 |
| MN | $354.16 | 1 |
| MO | $304.56–$332.74 | 3 |
| MS | $303.38 | 1 |
| MT | $347.70 | 1 |
| NC | $325.48 | 1 |
| ND | $345.52 | 1 |
| NE | $321.40 | 1 |
| NH | $360.03 | 1 |
| NJ | $378.04–$399.89 | 2 |
| NM | $322.55 | 1 |
| NV | $347.40 | 1 |
| NY | $331.01–$411.87 | 5 |
| OH | $320.59 | 1 |
| OK | $313.50 | 1 |
| OR | $345.36–$381.90 | 2 |
| PA | $321.92–$361.78 | 2 |
| PR | $351.08 | 1 |
| RI | $358.21 | 1 |
| SC | $323.44 | 1 |
| SD | $345.26 | 1 |
| TN | $317.61 | 1 |
| TX | $319.37–$365.44 | 8 |
| UT | $328.61 | 1 |
| VA | $341.32–$405.38 | 2 |
| VI | $351.08 | 1 |
| VT | $342.77 | 1 |
| WA | $363.78–$419.45 | 2 |
| WI | $332.06 | 1 |
| WV | $308.42 | 1 |
| WY | $346.75 | 1 |
How the 78265 rate is calculated
Each of 78265’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 · 78265
RVUs × geographic indexes × conversion factor
Work0.96
0.96 RVUs× 1.000 GPCI
Practice expense9.34
9.34 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
10.4100
Conversion factor
$33.4009
Medicare rate
$347.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Vermont inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,296
- Code
- 78265
- Physician work
- 0.96
- Practice expense
- 9.34
- Malpractice
- 0.11
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.96 | × 1.000 | 0.9600 |
| Practice expense | 9.34 | × 0.990 | 9.2466 |
| Malpractice | 0.11 | × 0.506 | 0.0557 |
| Total RVUs | 10.2623 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vermont$342.77
Office: (0.96 × 1 + 9.34 × 0.99 + 0.11 × 0.506) × $33.4009 = $342.77
Payment rules and modifiers for 78265
The CMS indicators that decide how 78265 is paid alongside other services.
CMS payment indicators · 78265
Gastric emptying, with small bowel transit
| 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
78265 without 26 · national office
$347.70
Gastric emptying, with small bowel transit
78265-26 · Professional component
$44.76
Pays only the interpretation and report.
How 78265 has changed in Vermont
78265 · Office / nonfacility
$342.77
Effective 2026-10-01
The base rate is $4.10 higher than on 2025-10-01, moving from $338.67 to $342.77 (1.2%).
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
$338.67changed to$342.77
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.98 changed to 0.96
- Practice expense RVU 9.51 changed to 9.34
- Malpractice RVU 0.09 changed to 0.11
- Practice expense GPCI 0.993 changed to 0.990
- Malpractice GPCI 0.518 changed to 0.506
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$354.64changed to$338.67
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.69 changed to 9.51
- Malpractice RVU 0.10 changed to 0.09
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$348.86changed to$354.64
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$367.16changed to$348.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.83 changed to 9.69
- Practice expense GPCI 0.997 changed to 0.993
- Malpractice GPCI 0.543 changed to 0.518
January 1, 2023
RVU23A
$382.14changed to$367.16
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.99 changed to 9.83
- Malpractice RVU 0.11 changed to 0.10
- Practice expense GPCI 1.001 changed to 0.997
- Malpractice GPCI 0.569 changed to 0.543
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$401.33changed to$382.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 10.46 changed to 9.99
- Malpractice RVU 0.09 changed to 0.11
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$407.65changed to$401.33
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 10.17 changed to 10.46
- Malpractice RVU 0.11 changed to 0.09
- Practice expense GPCI 1.008 changed to 1.001
- Malpractice GPCI 0.582 changed to 0.569
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$407.65
Held through RVU20B, RVU20C, RVU20D.
January 1, 2016
RVU16A
No ratechanged toNo rate
Held through RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $342.77 | Not available in this setting | RVU26D |
| 2026-07-01 | $342.77 | Not available in this setting | RVU26C |
| 2026-04-01 | $342.77 | Not available in this setting | RVU26B |
| 2026-01-01 | $342.77 | Not available in this setting | RVU26A |
| 2025-10-01 | $338.67 | Not available in this setting | RVU25D |
| 2025-07-01 | $338.67 | Not available in this setting | RVU25C |
| 2025-04-01 | $338.67 | Not available in this setting | RVU25B |
| 2025-01-01 | $338.67 | Not available in this setting | RVU25A |
| 2024-10-01 | $354.64 | Not available in this setting | RVU24D |
| 2024-07-01 | $354.64 | Not available in this setting | RVU24C |
| 2024-04-01 | $354.64 | Not available in this setting | RVU24B |
| 2024-03-09 | $354.64 | Not available in this setting | RVU24AR |
| 2024-01-01 | $348.86 | Not available in this setting | RVU24A |
| 2023-10-01 | $367.16 | Not available in this setting | RVU23D |
| 2023-07-01 | $367.16 | Not available in this setting | RVU23C |
| 2023-04-01 | $367.16 | Not available in this setting | RVU23B |
| 2023-01-01 | $367.16 | Not available in this setting | RVU23A |
| 2022-10-01 | $382.14 | Not available in this setting | RVU22D |
| 2022-07-01 | $382.14 | Not available in this setting | RVU22C |
| 2022-04-01 | $382.14 | Not available in this setting | RVU22B |
| 2022-01-01 | $382.14 | Not available in this setting | RVU22A |
| 2021-10-01 | $401.33 | Not available in this setting | RVU21D |
| 2021-07-01 | $401.33 | Not available in this setting | RVU21C |
| 2021-04-01 | $401.33 | Not available in this setting | RVU21B |
| 2021-01-01 | $401.33 | Not available in this setting | RVU21A |
| 2020-10-01 | $407.65 | Not available in this setting | RVU20D |
| 2020-07-01 | $407.65 | Not available in this setting | RVU20C |
| 2020-04-01 | $407.65 | Not available in this setting | RVU20B |
| 2020-01-01 | $407.65 | Not available in this setting | RVU20A |
| 2019-10-01 | Additional calculation required | Not available in this setting | RVU19D |
| 2019-07-01 | Additional calculation required | Not available in this setting | RVU19C |
| 2019-04-01 | Additional calculation required | Not available in this setting | RVU19B |
| 2019-01-01 | Additional calculation required | Not available in this setting | RVU19A |
| 2018-10-01 | Additional calculation required | Not available in this setting | RVU18D |
| 2018-07-01 | Additional calculation required | Not available in this setting | RVU18C |
| 2018-04-01 | Additional calculation required | Not available in this setting | RVU18B |
| 2018-01-01 | Additional calculation required | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Additional calculation required | Not available in this setting | RVU17D |
| 2017-07-01 | Additional calculation required | Not available in this setting | RVU17C |
| 2017-04-01 | Additional calculation required | Not available in this setting | RVU17B |
| 2017-01-01 | Additional calculation required | Not available in this setting | RVU17A |
| 2016-10-01 | Additional calculation required | Not available in this setting | RVU16D |
| 2016-07-01 | Additional calculation required | Not available in this setting | RVU16C |
| 2016-04-01 | Additional calculation required | Not available in this setting | RVU16B |
| 2016-01-01 | Additional calculation required | Not available in this setting | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
78265 billing questions
How does this differ from 78264?
Use 78265 when the study includes small bowel transit as well as gastric emptying. Code 78264 describes gastric emptying imaging without that transit component.
When is 78266 a better fit?
Use 78266 when the study follows transit through the small bowel and colon. This code covers gastric emptying with small bowel transit, without the colon-transit scope.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting this code?
Document that gastric emptying imaging included assessment of small bowel transit, along with the study performed and the interpretation. The documented scope helps distinguish it from gastric-only imaging and studies that also include colon transit.
Should 78264 also be reported for the gastric portion?
When the single study includes both gastric emptying and small bowel transit, report the code matching that combined scope rather than separately reporting 78264 for its gastric portion.
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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