CPT code 78278: GI bleeding scan, acute blood loss2026 Medicare rate & RVUs in California

Medicare pays $330.53–$426.92 for 78278 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 78278 covers

This study uses nuclear medicine imaging to look for and localize active blood loss into the gastrointestinal tract. A common approach uses the patient’s radiolabeled red blood cells, with serial imaging to follow suspected bleeding over time. It is typically performed in a nuclear medicine department for patients with suspected acute gastrointestinal hemorrhage, including cases in which bleeding is intermittent and localization is needed to guide care. A nuclear medicine physician or radiologist interprets the images; technologists perform the imaging and related technical work.

Report 78278 for imaging directed at acute GI blood loss, rather than a study aimed at another question such as gastric emptying or intestinal protein loss. The record should support the bleeding indication and include the study and interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Serial images within the study do not represent separate services.

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 78278 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 78278 rate is calculated

Each of 78278’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.

Payment rules and modifiers for 78278

The CMS indicators that decide how 78278 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78278 compared with similar codes

How to choose

78290Intestinal imagingEctopic gastric mucosa

78278 targets suspected GI blood loss; 78290 describes intestine imaging for a different diagnostic purpose.

78282Protein-loss imagingGastrointestinal tract

78282 evaluates gastrointestinal protein loss, not active bleeding.

78299GI nuclear medicineUnlisted procedure

Use 78278 when the performed study is the defined GI blood loss imaging service; 78299 is for an unlisted GI nuclear medicine procedure.

Codes related to 78278

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates