CPT code 78266: GI transit imaging, small bowel and colon transit2026 Medicare rate & RVUs in Montana
Reports scintigraphic assessment of gastric emptying together with small-bowel and colonic transit when clinicians evaluate suspected gastrointestinal motility delay.
In Montana, Medicare pays $394.79 for 78266 in the office.
Check a contract rate as a % of Medicare · 78266 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 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.
How Montana compares for 78266
Across 109 of 109 payment localities, the office rate for 78266 runs from $342.81 in Arkansas to $554.33 in San Benito County, CA. Montana pays $394.79. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$394.79
- Los Angeles, CA · California$460.16+$65.37
- Washington, DC area · District of Columbia$460.49+$65.70
- Miami, FL · Florida$415.01+$20.22
- Chicago, IL · Illinois$401.58+$6.79
- Manhattan, NY · New York$456.88+$62.09
- Alaska · Alaska$433.83+$39.04
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $348.70 | — |
| ArkansasArkansas | $342.81 | — |
| ArizonaArizona | $383.23 | — |
| Bakersfield, CACalifornia | $428.21 | — |
| Chico, CACalifornia | $427.87 | — |
| El Centro, CACalifornia | $427.89 | — |
| Fresno, CACalifornia | $427.87 | — |
| Hanford, CACalifornia | $427.87 | — |
| Madera, CACalifornia | $427.87 | — |
| Merced, CACalifornia | $427.87 | — |
| Modesto, CACalifornia | $427.87 | — |
| Napa, CACalifornia | $508.43 | — |
| Oxnard, CACalifornia | $459.20 | — |
| Redding, CACalifornia | $427.87 | — |
| Rest of CaliforniaCalifornia | $427.87 | — |
| Riverside, CACalifornia | $429.07 | — |
| Sacramento, CACalifornia | $452.39 | — |
| Salinas, CACalifornia | $450.79 | — |
| San Diego, CACalifornia | $463.95 | — |
| Marin County, CACalifornia | $542.12 | — |
| San Francisco, CACalifornia | $542.00 | — |
| San Benito County, CACalifornia | $554.33 | — |
| Santa Clara County, CACalifornia | $553.82 | — |
| San Luis Obispo, CACalifornia | $443.18 | — |
| Santa Cruz, CACalifornia | $470.38 | — |
| Santa Maria, CACalifornia | $453.18 | — |
| Santa Rosa, CACalifornia | $475.33 | — |
| Stockton, CACalifornia | $427.87 | — |
| Vallejo, CACalifornia | $508.25 | — |
| Visalia, CACalifornia | $427.87 | — |
| Yuba City, CACalifornia | $427.87 | — |
| ColoradoColorado | $417.20 | — |
| ConnecticutConnecticut | $423.69 | — |
| DelawareDelaware | $390.33 | — |
| Fort Lauderdale, FLFlorida | $402.40 | — |
| Rest of FloridaFlorida | $380.98 | — |
| Atlanta, GAGeorgia | $401.34 | — |
| Rest of GeorgiaGeorgia | $357.05 | — |
| Hawaii, Guam, HIHawaii | $442.03 | — |
| IowaIowa | $362.32 | — |
| IdahoIdaho | $364.38 | — |
| East St. Louis, ILIllinois | $370.04 | — |
| Rest of IllinoisIllinois | $365.89 | — |
| Suburban Chicago, ILIllinois | $407.49 | — |
| IndianaIndiana | $366.92 | — |
| KansasKansas | $358.80 | — |
| KentuckyKentucky | $354.96 | — |
| New Orleans, LALouisiana | $374.29 | — |
| Rest of LouisianaLouisiana | $353.70 | — |
| Metropolitan Boston, MAMassachusetts | $464.91 | — |
| Rest of MassachusettsMassachusetts | $413.48 | — |
| Baltimore area, MDMaryland | $422.22 | — |
| Rest of MarylandMaryland | $399.12 | — |
| Rest of MaineMaine | $364.93 | — |
| Southern Maine, MEMaine | $390.24 | — |
| Detroit, MIMichigan | $384.86 | — |
| Rest of MichiganMichigan | $364.30 | — |
| MinnesotaMinnesota | $402.54 | — |
| Metropolitan Kansas City, MOMissouri | $372.99 | — |
| Metropolitan St. Louis, MOMissouri | $377.72 | — |
| Rest of MissouriMissouri | $345.57 | — |
| MississippiMississippi | $344.35 | — |
| North CarolinaNorth Carolina | $369.62 | — |
| North DakotaNorth Dakota | $392.62 | — |
| NebraskaNebraska | $365.10 | — |
| New HampshireNew Hampshire | $408.94 | — |
| Northern New JerseyNew Jersey | $454.23 | — |
| Rest of New JerseyNew Jersey | $429.31 | — |
| New MexicoNew Mexico | $365.98 | — |
| NevadaNevada | $394.54 | — |
| NYC suburbs and Long Island, NYNew York | $467.49 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $430.97 | — |
| Queens, NYNew York | $463.47 | — |
| Rest of New YorkNew York | $375.90 | — |
| OhioOhio | $363.85 | — |
| OklahomaOklahoma | $355.88 | — |
| Portland, OROregon | $433.94 | — |
| Rest of OregonOregon | $392.28 | — |
| Metropolitan Philadelphia, PAPennsylvania | $410.74 | — |
| Rest of PennsylvaniaPennsylvania | $365.40 | — |
| Puerto RicoPuerto Rico | $398.66 | — |
| Rhode IslandRhode Island | $406.82 | — |
| South CarolinaSouth Carolina | $367.19 | — |
| South DakotaSouth Dakota | $392.36 | — |
| TennesseeTennessee | $360.70 | — |
| Austin, TXTexas | $415.10 | — |
| Beaumont, TXTexas | $362.49 | — |
| Brazoria, TXTexas | $391.07 | — |
| Dallas, TXTexas | $393.17 | — |
| Fort Worth, TXTexas | $389.66 | — |
| Galveston, TXTexas | $391.95 | — |
| Houston, TXTexas | $393.97 | — |
| Rest of TexasTexas | $376.28 | — |
| UtahUtah | $373.06 | — |
| VirginiaVirginia | $387.67 | — |
| Virgin Islands, VIUnited States Virgin Islands | $398.66 | — |
| VermontVermont | $389.42 | — |
| Rest of WashingtonWashington | $413.25 | — |
| King County, WAWashington | $476.70 | — |
| WisconsinWisconsin | $377.30 | — |
| West VirginiaWest Virginia | $349.74 | — |
| WyomingWyoming | $393.84 | — |
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.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,299
- Code
- 78266
- Physician work
- 1.05
- Practice expense
- 10.66
- Malpractice
- 0.11
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.000 | 1.0500 |
| Practice expense | 10.66 | × 1.000 | 10.6600 |
| Malpractice | 0.11 | × 0.998 | 0.1098 |
| Total RVUs | 11.8198 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$394.79
Office: (1.05 × 1 + 10.66 × 1 + 0.11 × 0.998) × $33.4009 = $394.79
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.
How 78266 has changed in Montana
78266 · Office / nonfacility
$394.79
Effective 2026-10-01
The base rate is $9.94 higher than on 2025-10-01, moving from $384.85 to $394.79 (2.6%).
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
$384.85changed to$394.79
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.08 changed to 1.05
- Practice expense RVU 10.72 changed to 10.66
- Malpractice RVU 0.10 changed to 0.11
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$407.69changed to$384.85
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 11.06 changed to 10.72
- Malpractice RVU 0.11 changed to 0.10
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$401.04changed to$407.69
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$420.12changed to$401.04
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 11.21 changed to 11.06
January 1, 2023
RVU23A
$430.06changed to$420.12
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 11.23 changed to 11.21
- Malpractice RVU 0.12 changed to 0.11
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$446.55changed to$430.06
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 11.62 changed to 11.23
- Malpractice RVU 0.10 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$445.25changed to$446.55
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 11.14 changed to 11.62
- Malpractice RVU 0.09 changed to 0.10
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$491.91changed to$445.25
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 12.39 changed to 11.14
- Malpractice RVU 0.11 changed to 0.09
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$503.97changed to$491.91
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 12.74 changed to 12.39
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
No ratechanged to$503.97
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$494.99changed toNo rate
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$494.99
Held through RVU16B, RVU16C, RVU16D.
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 | $394.79 | Not available in this setting | RVU26D |
| 2026-07-01 | $394.79 | Not available in this setting | RVU26C |
| 2026-04-01 | $394.79 | Not available in this setting | RVU26B |
| 2026-01-01 | $394.79 | Not available in this setting | RVU26A |
| 2025-10-01 | $384.85 | Not available in this setting | RVU25D |
| 2025-07-01 | $384.85 | Not available in this setting | RVU25C |
| 2025-04-01 | $384.85 | Not available in this setting | RVU25B |
| 2025-01-01 | $384.85 | Not available in this setting | RVU25A |
| 2024-10-01 | $407.69 | Not available in this setting | RVU24D |
| 2024-07-01 | $407.69 | Not available in this setting | RVU24C |
| 2024-04-01 | $407.69 | Not available in this setting | RVU24B |
| 2024-03-09 | $407.69 | Not available in this setting | RVU24AR |
| 2024-01-01 | $401.04 | Not available in this setting | RVU24A |
| 2023-10-01 | $420.12 | Not available in this setting | RVU23D |
| 2023-07-01 | $420.12 | Not available in this setting | RVU23C |
| 2023-04-01 | $420.12 | Not available in this setting | RVU23B |
| 2023-01-01 | $420.12 | Not available in this setting | RVU23A |
| 2022-10-01 | $430.06 | Not available in this setting | RVU22D |
| 2022-07-01 | $430.06 | Not available in this setting | RVU22C |
| 2022-04-01 | $430.06 | Not available in this setting | RVU22B |
| 2022-01-01 | $430.06 | Not available in this setting | RVU22A |
| 2021-10-01 | $446.55 | Not available in this setting | RVU21D |
| 2021-07-01 | $446.55 | Not available in this setting | RVU21C |
| 2021-04-01 | $446.55 | Not available in this setting | RVU21B |
| 2021-01-01 | $446.55 | Not available in this setting | RVU21A |
| 2020-10-01 | $445.25 | Not available in this setting | RVU20D |
| 2020-07-01 | $445.25 | Not available in this setting | RVU20C |
| 2020-04-01 | $445.25 | Not available in this setting | RVU20B |
| 2020-01-01 | $445.25 | Not available in this setting | RVU20A |
| 2019-10-01 | $491.91 | Not available in this setting | RVU19D |
| 2019-07-01 | $491.91 | Not available in this setting | RVU19C |
| 2019-04-01 | $491.91 | Not available in this setting | RVU19B |
| 2019-01-01 | $491.91 | Not available in this setting | RVU19A |
| 2018-10-01 | $503.97 | Not available in this setting | RVU18D |
| 2018-07-01 | $503.97 | Not available in this setting | RVU18C |
| 2018-04-01 | $503.97 | Not available in this setting | RVU18B |
| 2018-01-01 | $503.97 | 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 | $494.99 | Not available in this setting | RVU16D |
| 2016-07-01 | $494.99 | Not available in this setting | RVU16C |
| 2016-04-01 | $494.99 | Not available in this setting | RVU16B |
| 2016-01-01 | $494.99 | 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 Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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
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