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

Nuclear medicine imaging tracks suspected active gastrointestinal bleeding to help localize blood loss, including bleeding that may occur intermittently.

CMS RVU26DEffective Oct 1, 2026One payment locality11.6K Medicare services in 2024

In South Dakota, Medicare pays $303.40 for 78278 in the office.

$303.40Office (non-facility)
Not available in this settingHospital or facility
−0.7%vs the national office rate ($305.62)

Check a contract rate as a % of Medicare · 78278 nationwide

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

We’ll open 78278 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 78278 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How South Dakota compares for 78278

Across 109 of 109 payment localities, the office rate for 78278 runs from $265.95 in Arkansas to $426.92 in San Benito County, CA. South Dakota pays $303.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

78278 in South Dakota vs other payment areas
  1. South Dakota · this page$303.40
  2. Los Angeles, CA · California$355.21+$51.81
  3. Washington, DC area · District of Columbia$355.78+$52.38
  4. Miami, FL · Florida$321.79+$18.39
  5. Chicago, IL · Illinois$311.52+$8.12
  6. Manhattan, NY · New York$353.37+$49.97
  7. Alaska · Alaska$337.86+$34.46

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

78278 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$270.43—
ArkansasArkansas$265.95—
ArizonaArizona$296.77—
Bakersfield, CACalifornia$330.84—
Chico, CACalifornia$330.53—
El Centro, CACalifornia$330.54—
Fresno, CACalifornia$330.53—
Hanford, CACalifornia$330.53—

78278 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.

$265.95

$378.73

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78278 office rate range by state
State / territoryOffice rate rangeLocalities
AK$337.861
AL$270.431
AR$265.951
AZ$296.771
CA$330.53–$426.9229
CO$322.551
CT$327.751
DC$355.781
DE$302.201
FL$295.42–$321.793
GA$277.11–$310.702
GU$341.191
HI$341.191
IA$280.661
ID$282.271
IL$284.02–$315.714
IN$284.201
KS$278.051
KY$275.381
LA$274.44–$290.152
MA$319.76–$358.942
MD$308.91–$355.783
ME$282.77–$301.962
MI$282.57–$298.462
MN$311.091
MO$268.29–$292.673
MS$267.231
MT$305.611
NC$286.331
ND$303.631
NE$282.761
NH$316.271
NJ$332.07–$351.072
NM$283.891
NV$305.331
NY$291.13–$361.565
OH$282.171
OK$276.001
OR$303.55–$335.242
PA$283.30–$317.912
PR$308.541
RI$314.781
SC$284.611
SD$303.401
TN$279.511
TX$281.09–$320.968
UT$289.081
VA$300.05–$355.782
VI$308.541
VT$301.271
WA$319.54–$367.892
WI$291.971
WV$271.701
WY$304.751

See 78278 in every payment locality

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.

How the rate is built · 78278

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.97

0.97 RVUs× 1.000 GPCI

Practice expense8.08

8.08 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

9.1500

Conversion factor

$33.4009

Medicare rate

$305.62

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,304

Code
78278
Physician work
0.97
Practice expense
8.08
Malpractice
0.10

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 78278 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.97× 1.0000.9700
Practice expense8.08× 1.0008.0800
Malpractice0.10× 0.3360.0336
Total RVUs9.0836
Conversion factor× 33.4009

Office rate, South Dakota$303.40

Office: (0.97 × 1 + 8.08 × 1 + 0.1 × 0.336) × $33.4009 = $303.40

Open 78278 in the RVU calculator

Payment rules and modifiers for 78278

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

CMS payment indicators · 78278

GI bleeding scan, acute blood loss

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

78278 without 26 · national office

$305.62

GI bleeding scan, acute blood loss

78278-26 · Professional component

$45.09

Pays only the interpretation and report.

When to use modifier 26

How 78278 has changed in South Dakota

78278 · Office / nonfacility

$303.40

Effective 2026-10-01

The base rate is $2.11 higher than on 2025-10-01, moving from $301.29 to $303.40 (0.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $301.29changed to$303.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.99 changed to 0.97
    • Practice expense RVU 8.29 changed to 8.08
    • Malpractice RVU 0.09 changed to 0.10
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $315.97changed to$301.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.46 changed to 8.29
    • Malpractice RVU 0.11 changed to 0.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $310.81changed to$315.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $327.66changed to$310.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.65 changed to 8.46
    • Malpractice RVU 0.08 changed to 0.11
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $339.18changed to$327.66

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.78 changed to 8.65
    • Malpractice RVU 0.09 changed to 0.08
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $355.25changed to$339.18

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.16 changed to 8.78

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $357.53changed to$355.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.88 changed to 9.16
    • Malpractice RVU 0.10 changed to 0.09
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $360.57changed to$357.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.98 changed to 8.88
    • Malpractice RVU 0.09 changed to 0.10
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $366.30changed to$360.57

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.15 changed to 8.98

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $363.75changed to$366.30

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.11 changed to 9.15
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $362.20changed to$363.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.09 changed to 9.11
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $362.21changed to$362.20

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.05 changed to 9.09
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $360.41changed to$362.21

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $354.76changed to$360.41

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.88 changed to 9.05
    • Malpractice RVU 0.08 changed to 0.10
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$354.76

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$303.40Not available in this settingRVU26D
2026-07-01$303.40Not available in this settingRVU26C
2026-04-01$303.40Not available in this settingRVU26B
2026-01-01$303.40Not available in this settingRVU26A
2025-10-01$301.29Not available in this settingRVU25D
2025-07-01$301.29Not available in this settingRVU25C
2025-04-01$301.29Not available in this settingRVU25B
2025-01-01$301.29Not available in this settingRVU25A
2024-10-01$315.97Not available in this settingRVU24D
2024-07-01$315.97Not available in this settingRVU24C
2024-04-01$315.97Not available in this settingRVU24B
2024-03-09$315.97Not available in this settingRVU24AR
2024-01-01$310.81Not available in this settingRVU24A
2023-10-01$327.66Not available in this settingRVU23D
2023-07-01$327.66Not available in this settingRVU23C
2023-04-01$327.66Not available in this settingRVU23B
2023-01-01$327.66Not available in this settingRVU23A
2022-10-01$339.18Not available in this settingRVU22D
2022-07-01$339.18Not available in this settingRVU22C
2022-04-01$339.18Not available in this settingRVU22B
2022-01-01$339.18Not available in this settingRVU22A
2021-10-01$355.25Not available in this settingRVU21D
2021-07-01$355.25Not available in this settingRVU21C
2021-04-01$355.25Not available in this settingRVU21B
2021-01-01$355.25Not available in this settingRVU21A
2020-10-01$357.53Not available in this settingRVU20D
2020-07-01$357.53Not available in this settingRVU20C
2020-04-01$357.53Not available in this settingRVU20B
2020-01-01$357.53Not available in this settingRVU20A
2019-10-01$360.57Not available in this settingRVU19D
2019-07-01$360.57Not available in this settingRVU19C
2019-04-01$360.57Not available in this settingRVU19B
2019-01-01$360.57Not available in this settingRVU19A
2018-10-01$366.30Not available in this settingRVU18D
2018-07-01$366.30Not available in this settingRVU18C
2018-04-01$366.30Not available in this settingRVU18B
2018-01-01$366.30Not available in this settingRVU18AR1
2017-10-01$363.75Not available in this settingRVU17D
2017-07-01$363.75Not available in this settingRVU17C
2017-04-01$363.75Not available in this settingRVU17B
2017-01-01$363.75Not available in this settingRVU17A
2016-10-01$362.20Not available in this settingRVU16D
2016-07-01$362.20Not available in this settingRVU16C
2016-04-01$362.20Not available in this settingRVU16B
2016-01-01$362.20Not available in this settingRVU16A
2015-10-01$362.21Not available in this settingRVU15D
2015-07-01$362.21Not available in this settingRVU15C
2015-04-01$360.41Not available in this settingRVU15B
2015-01-01$360.41Not available in this settingRVU15A
2014-10-01$354.76Not available in this settingRVU14D
2014-07-01$354.76Not available in this settingRVU14C
2014-04-01$354.76Not available in this settingRVU14B
2014-01-01$354.76Not available in this settingRVU14A
2013-10-01Additional calculation requiredNot available in this settingRVU13D
2013-07-01Additional calculation requiredNot available in this settingRVU13C
2013-04-01Additional calculation requiredNot available in this settingRVU13B
2013-01-01Additional calculation requiredNot available in this settingRVU13AR

Price 78278 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

78278 billing questions

When should 78278 be selected instead of intestine imaging?

Use 78278 when the imaging is directed at locating suspected gastrointestinal blood loss. Intestinal imaging such as 78290 addresses a different diagnostic question.

Can the interpretation and imaging be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

Are serial images separate units?

No. Serial images used to follow possible bleeding are part of the imaging study, not separate services.

What documentation supports reporting 78278?

Document the suspected acute GI bleeding indication and the imaging performed to detect or localize blood loss. The interpretation should describe the findings relevant to that question.

Is a radiopharmaceutical code commonly reported with this study?

The radiolabeled red blood cell supply may be reported separately when applicable; A9560 identifies technetium Tc-99m labeled red blood cells.

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 78278PPRRVU2026_Oct_nonQPP.csv, line 9,304 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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