CPT code 78290: Intestinal imaging, ectopic gastric mucosa2026 Medicare rate & RVUs in Missouri
Reports intestinal scintigraphy, commonly used to locate ectopic gastric mucosa such as in suspected Meckel diverticulum, with professional and technical components available.
Medicare pays $254.15–$278.17 for 78290 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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.
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On this page 9 sections
What 78290 covers
This nuclear medicine examination images the intestine, commonly to detect ectopic gastric mucosa in a patient being evaluated for a Meckel diverticulum. A nuclear medicine technologist performs the imaging, and a nuclear medicine physician interprets the study. It is typically performed in a hospital or outpatient nuclear medicine department; a common clinical presentation is a child with painless gastrointestinal bleeding and suspected Meckel diverticulum.
Select this code when the study is directed at intestinal localization, rather than gastric emptying, bowel transit, or active bleeding localization. Documentation should identify the clinical indication, imaging performed, and interpretation supporting the intestinal focus. CMS allows the service to be billed globally without a component modifier, or split between the professional interpretation with modifier 26 and the technical service with modifier TC. The technical component represents the equipment and staff; the professional component represents interpretation.
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 78290 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$254.15 to $278.17
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $274.63 | Unavailable |
| Metropolitan St. Louis, MO | $278.17 | Unavailable |
| Rest of Missouri | $254.15 | Unavailable |
How the 78290 rate is calculated
Each of 78290’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 · 78290
RVUs × geographic indexes × conversion factor
Work0.66
0.66 RVUs× 1.000 GPCI
Practice expense7.96
7.96 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
8.7100
Conversion factor
$33.4009
Medicare rate
$290.92
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78290
The CMS indicators that decide how 78290 is paid alongside other services.
CMS payment indicators · 78290
Intestinal imaging, ectopic gastric mucosa
| 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
78290 without 26 · national office
$290.92
Intestinal imaging, ectopic gastric mucosa
78290-26 · Professional component
$31.06
Pays only the interpretation and report.
78290 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78261Gastric mucosa scanEctopic tissue localization
- Choose 78290 for an intestine-directed study, commonly to locate ectopic gastric mucosa. Choose 78261 when the imaging target is the gastric mucosa.
- 78278GI bleeding scanAcute blood loss
- 78278 is for imaging to localize acute gastrointestinal blood loss; 78290 is used for intestinal imaging such as evaluation for ectopic gastric mucosa.
- 78265Gastric emptyingWith small bowel transit
- 78265 evaluates gastric emptying and includes small-bowel transit imaging. It is not the code for an intestinal study directed at ectopic gastric mucosa.
78290 billing questions
When is this code appropriate for a suspected Meckel diverticulum?
Use it when the nuclear medicine study is directed at locating ectopic gastric mucosa in the intestine, a common reason to evaluate for Meckel diverticulum.
How does this differ from gastric mucosa imaging?
This code represents intestine-directed imaging, often for ectopic gastric mucosa. Use gastric mucosa imaging when the study is directed at the stomach itself.
Can the professional and technical services be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical service; without either modifier, the claim represents the global service.
What documentation supports reporting this code?
The record should establish the intestinal imaging indication, such as suspected ectopic gastric mucosa, and include the imaging performed and the interpreting physician's findings.
Is this the code for locating active gastrointestinal bleeding?
Use the acute gastrointestinal blood-loss imaging code when the study is directed at localizing active bleeding. This code is for intestinal imaging such as evaluation for ectopic gastric mucosa.
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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