CPT code 78266: GI transit imaging, small bowel and colon transit2026 Medicare rate & RVUs in Massachusetts

Reports scintigraphic assessment of gastric emptying together with small-bowel and colonic transit when clinicians evaluate suspected gastrointestinal motility delay.

CMS RVU26DEffective Oct 1, 20262 payment localities316 Medicare services in 2024

Medicare pays $413.48–$464.91 for 78266 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.

$413.48–$464.91Office (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 Massachusetts
  2. What 78266 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 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 in Massachusetts

78266 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Boston, MA$464.91Unavailable
Rest of Massachusetts$413.48Unavailable

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

Office or facility?

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

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

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.

When to use modifier 26

78266 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78266

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

    $394.80

  • 78264

    Gastric emptying, stomach only0.77 wRVU

    $289.92−$104.88

  • 78265

    Gastric emptying, with small bowel transit0.96 wRVU

    $347.70−$47.10

  • 78262

    Reflux imaging, gastroesophageal reflux0.66 wRVU

    $217.44−$177.36

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

Show the CMS file lines behind this rate
RVUs for 78266PPRRVU2026_Oct_nonQPP.csv, line 9,299 (RVU26D)

Open CMS sourceHow we calculate rates

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