CPT code 78266: GI transit imaging, small bowel and colon transit2026 Medicare rate & RVUs
Reports scintigraphic assessment of gastric emptying together with small-bowel and colonic transit when clinicians evaluate suspected gastrointestinal motility delay.
Medicare pays $394.80 for 78266 nationally in the office. Local office rates run $342.81–$554.33.
Medicare rate · 78266
GI transit imaging, small bowel and colon transit
- Work RVUs
- 1.05
- Total RVUs
- 11.82
- Global days
- XXX
National rate · 2026
$394.80
Office setting, before claim adjustments.
See every locality for 78266 →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 78266 covers
This nuclear medicine study tracks a radiolabeled meal as it moves from the stomach through the small bowel and colon. It can help evaluate suspected gastroparesis or broader gastrointestinal transit delay. A nuclear medicine physician or radiologist interprets the images, commonly following a study performed in an imaging department or hospital radiology service.
Report 78266 when the examination assesses gastric emptying and transit through both the small bowel and colon; the documented scope of the study distinguishes it from gastric-only or gastric-plus-small-bowel imaging. The record should support the combined evaluation and include the interpreting physician’s findings. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service. The global service includes both components.
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 78266 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
$342.81 to $554.33
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $348.70 | Unavailable |
| Alaska | $433.83 | Unavailable |
| Arizona | $383.23 | Unavailable |
| Arkansas | $342.81 | Unavailable |
| Atlanta, GA | $401.34 | Unavailable |
| Austin, TX | $415.10 | Unavailable |
| Bakersfield, CA | $428.21 | Unavailable |
| Baltimore area, MD | $422.22 | Unavailable |
| Beaumont, TX | $362.49 | Unavailable |
| Brazoria, TX | $391.07 | Unavailable |
| Chicago, IL | $401.58 | Unavailable |
| Chico, CA | $427.87 | Unavailable |
| Colorado | $417.20 | Unavailable |
| Connecticut | $423.69 | Unavailable |
| Dallas, TX | $393.17 | Unavailable |
| Delaware | $390.33 | Unavailable |
| Detroit, MI | $384.86 | Unavailable |
| East St. Louis, IL | $370.04 | Unavailable |
| El Centro, CA | $427.89 | Unavailable |
| Fort Lauderdale, FL | $402.40 | Unavailable |
| Fort Worth, TX | $389.66 | Unavailable |
| Fresno, CA | $427.87 | Unavailable |
| Galveston, TX | $391.95 | Unavailable |
| Hanford, CA | $427.87 | Unavailable |
| Hawaii, Guam, HI | $442.03 | Unavailable |
| Houston, TX | $393.97 | Unavailable |
| Idaho | $364.38 | Unavailable |
| Indiana | $366.92 | Unavailable |
| Iowa | $362.32 | Unavailable |
| Kansas | $358.80 | Unavailable |
| Kentucky | $354.96 | Unavailable |
| King County, WA | $476.70 | Unavailable |
| Los Angeles, CA | $460.16 | Unavailable |
| Madera, CA | $427.87 | Unavailable |
| Manhattan, NY | $456.88 | Unavailable |
| Marin County, CA | $542.12 | Unavailable |
| Merced, CA | $427.87 | Unavailable |
| Metropolitan Boston, MA | $464.91 | Unavailable |
| Metropolitan Kansas City, MO | $372.99 | Unavailable |
| Metropolitan Philadelphia, PA | $410.74 | Unavailable |
| Metropolitan St. Louis, MO | $377.72 | Unavailable |
| Miami, FL | $415.01 | Unavailable |
| Minnesota | $402.54 | Unavailable |
| Mississippi | $344.35 | Unavailable |
| Modesto, CA | $427.87 | Unavailable |
| Montana | $394.79 | Unavailable |
| Napa, CA | $508.43 | Unavailable |
| Nebraska | $365.10 | Unavailable |
| Nevada | $394.54 | Unavailable |
| New Hampshire | $408.94 | Unavailable |
| New Mexico | $365.98 | Unavailable |
| New Orleans, LA | $374.29 | Unavailable |
| North Carolina | $369.62 | Unavailable |
| North Dakota | $392.62 | Unavailable |
| Northern New Jersey | $454.23 | Unavailable |
| NYC suburbs and Long Island, NY | $467.49 | Unavailable |
| Ohio | $363.85 | Unavailable |
| Oklahoma | $355.88 | Unavailable |
| Oxnard, CA | $459.20 | Unavailable |
| Portland, OR | $433.94 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $430.97 | Unavailable |
| Puerto Rico | $398.66 | Unavailable |
| Queens, NY | $463.47 | Unavailable |
| Redding, CA | $427.87 | Unavailable |
| Rest of California | $427.87 | Unavailable |
| Rest of Florida | $380.98 | Unavailable |
| Rest of Georgia | $357.05 | Unavailable |
| Rest of Illinois | $365.89 | Unavailable |
| Rest of Louisiana | $353.70 | Unavailable |
| Rest of Maine | $364.93 | Unavailable |
| Rest of Maryland | $399.12 | Unavailable |
| Rest of Massachusetts | $413.48 | Unavailable |
| Rest of Michigan | $364.30 | Unavailable |
| Rest of Missouri | $345.57 | Unavailable |
| Rest of New Jersey | $429.31 | Unavailable |
| Rest of New York | $375.90 | Unavailable |
| Rest of Oregon | $392.28 | Unavailable |
| Rest of Pennsylvania | $365.40 | Unavailable |
| Rest of Texas | $376.28 | Unavailable |
| Rest of Washington | $413.25 | Unavailable |
| Rhode Island | $406.82 | Unavailable |
| Riverside, CA | $429.07 | Unavailable |
| Sacramento, CA | $452.39 | Unavailable |
| Salinas, CA | $450.79 | Unavailable |
| San Benito County, CA | $554.33 | Unavailable |
| San Diego, CA | $463.95 | Unavailable |
| San Francisco, CA | $542.00 | Unavailable |
| San Luis Obispo, CA | $443.18 | Unavailable |
| Santa Clara County, CA | $553.82 | Unavailable |
| Santa Cruz, CA | $470.38 | Unavailable |
| Santa Maria, CA | $453.18 | Unavailable |
| Santa Rosa, CA | $475.33 | Unavailable |
| South Carolina | $367.19 | Unavailable |
| South Dakota | $392.36 | Unavailable |
| Southern Maine, ME | $390.24 | Unavailable |
| Stockton, CA | $427.87 | Unavailable |
| Suburban Chicago, IL | $407.49 | Unavailable |
| Tennessee | $360.70 | Unavailable |
| Utah | $373.06 | Unavailable |
| Vallejo, CA | $508.25 | Unavailable |
| Vermont | $389.42 | Unavailable |
| Virgin Islands, VI | $398.66 | Unavailable |
| Virginia | $387.67 | Unavailable |
| Visalia, CA | $427.87 | Unavailable |
| Washington, DC area | $460.49 | Unavailable |
| West Virginia | $349.74 | Unavailable |
| Wisconsin | $377.30 | Unavailable |
| Wyoming | $393.84 | Unavailable |
| Yuba City, CA | $427.87 | Unavailable |
78266 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.
$342.81
$491.10
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 | $433.83 | 1 |
| AL | $348.70 | 1 |
| AR | $342.81 | 1 |
| AZ | $383.23 | 1 |
| CA | $427.87–$554.33 | 29 |
| CO | $417.20 | 1 |
| CT | $423.69 | 1 |
| DC | $460.49 | 1 |
| DE | $390.33 | 1 |
| FL | $380.98–$415.01 | 3 |
| GA | $357.05–$401.34 | 2 |
| GU | $442.03 | 1 |
| HI | $442.03 | 1 |
| IA | $362.32 | 1 |
| ID | $364.38 | 1 |
| IL | $365.89–$407.49 | 4 |
| IN | $366.92 | 1 |
| KS | $358.80 | 1 |
| KY | $354.96 | 1 |
| LA | $353.70–$374.29 | 2 |
| MA | $413.48–$464.91 | 2 |
| MD | $399.12–$460.49 | 3 |
| ME | $364.93–$390.24 | 2 |
| MI | $364.30–$384.86 | 2 |
| MN | $402.54 | 1 |
| MO | $345.57–$377.72 | 3 |
| MS | $344.35 | 1 |
| MT | $394.79 | 1 |
| NC | $369.62 | 1 |
| ND | $392.62 | 1 |
| NE | $365.10 | 1 |
| NH | $408.94 | 1 |
| NJ | $429.31–$454.23 | 2 |
| NM | $365.98 | 1 |
| NV | $394.54 | 1 |
| NY | $375.90–$467.49 | 5 |
| OH | $363.85 | 1 |
| OK | $355.88 | 1 |
| OR | $392.28–$433.94 | 2 |
| PA | $365.40–$410.74 | 2 |
| PR | $398.66 | 1 |
| RI | $406.82 | 1 |
| SC | $367.19 | 1 |
| SD | $392.36 | 1 |
| TN | $360.70 | 1 |
| TX | $362.49–$415.10 | 8 |
| UT | $373.06 | 1 |
| VA | $387.67–$460.49 | 2 |
| VI | $398.66 | 1 |
| VT | $389.42 | 1 |
| WA | $413.25–$476.70 | 2 |
| WI | $377.30 | 1 |
| WV | $349.74 | 1 |
| WY | $393.84 | 1 |
How the 78266 rate is calculated
Each of 78266’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 · 78266
RVUs × geographic indexes × conversion factor
Work1.05
1.05 RVUs× 1.000 GPCI
Practice expense10.66
10.66 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
11.8200
Conversion factor
$33.4009
Medicare rate
$394.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78266
The CMS indicators that decide how 78266 is paid alongside other services.
CMS payment indicators · 78266
GI transit imaging, small bowel and colon 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
78266 without 26 · national office
$394.80
GI transit imaging, small bowel and colon transit
78266-26 · Professional component
$47.43
Pays only the interpretation and report.
78266 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78264Gastric emptyingStomach only
- Use 78264 for gastric emptying imaging alone. 78266 also evaluates transit through the small bowel and colon.
- 78265Gastric emptyingWith small bowel transit
- Use 78265 for gastric emptying with small-bowel transit when colonic transit is not part of the study; 78266 includes colonic transit.
- 78262Reflux imagingGastroesophageal reflux
- 78262 evaluates gastroesophageal reflux. It is not the code for tracking gastric emptying and subsequent intestinal transit.
78266 billing questions
How does 78266 differ from 78265?
78266 includes assessment of colonic transit in addition to gastric emptying and small-bowel transit. Use 78265 when the study does not include the colonic transit assessment.
Can 78264 or 78265 also be reported for the same examination?
Do not separately report a gastric-only or gastric-plus-small-bowel code for portions of the same combined examination represented by 78266.
When should modifier 26 or TC be used?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical service, including equipment and staff. Bill without either modifier when billing the global service.
What documentation supports 78266?
Document that the imaging evaluation covers gastric emptying and transit through both the small bowel and colon, along with the interpreting physician’s findings.
Are serial images reported as separate units?
The serial images are part of the combined transit study. Report the study rather than billing a separate unit for each image or time point.
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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