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CPT code 78709: Renal imaging, multiple flow and function studies2026 Medicare rate & RVUs in Iowa

Reports nuclear medicine kidney imaging that evaluates blood flow and function across multiple studies, rather than a single renal flow and function study.

CMS RVU26DEffective Oct 1, 2026One payment locality3.8K Medicare services in 2024

In Iowa, Medicare pays $300.23 for 78709 in the office.

$300.23Office (non-facility)
Not available in this settingHospital or facility
−8.0%vs the national office rate ($326.33)

Check a contract rate as a % of Medicare · 78709 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 78709 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 78709 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 78709 covers

This service uses a radiopharmaceutical and nuclear imaging to assess renal perfusion and function across multiple studies. A nuclear medicine technologist typically acquires the images in a hospital department or imaging center, and a physician interprets the findings. Such imaging may help evaluate renal function or suspected urinary obstruction; the documented protocol should make clear what studies were performed and what they assessed.

Select this code when the service comprises multiple kidney flow and function studies, not simply multiple images or views within one study. The report should identify the study protocols and findings supporting that scope. CMS recognizes professional and technical components: report modifier 26 for the physician’s interpretation, modifier TC for the equipment and staff, or neither modifier for the global service. CMS separately prices both modifiers.

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 Iowa compares for 78709

Across 109 of 109 payment localities, the office rate for 78709 runs from $285.27 in Arkansas to $451.44 in San Benito County, CA. Iowa pays $300.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

78709 in Iowa vs other payment areas
  1. Iowa · this page$300.23
  2. Los Angeles, CA · California$377.29+$77.06
  3. Washington, DC area · District of Columbia$378.46+$78.23
  4. Miami, FL · Florida$344.29+$44.06
  5. Chicago, IL · Illinois$333.65+$33.42
  6. Manhattan, NY · New York$376.55+$76.32
  7. Alaska · Alaska$365.21+$64.98

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

Every other payment area

78709 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$289.91—
ArkansasArkansas$285.27—
ArizonaArizona$317.14—
Bakersfield, CACalifornia$352.02—
Chico, CACalifornia$351.61—
El Centro, CACalifornia$351.63—
Fresno, CACalifornia$351.61—
Hanford, CACalifornia$351.61—

78709 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$285.27

$401.53

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

View every state and territory as a table
78709 office rate range by state
State / territoryOffice rate rangeLocalities
AK$365.211
AL$289.911
AR$285.271
AZ$317.141
CA$351.61–$451.4429
CO$343.601
CT$349.421
DC$378.461
DE$322.801
FL$316.36–$344.293
GA$297.33–$331.762
GU$362.341
HI$362.341
IA$300.231
ID$301.941
IL$304.74–$337.464
IN$303.931
KS$297.661
KY$295.301
LA$294.38–$310.622
MA$340.82–$381.312
MD$329.74–$378.463
ME$302.59–$322.242
MI$302.86–$319.642
MN$331.281
MO$288.09–$313.083
MS$286.801
MT$326.321
NC$306.251
ND$323.751
NE$302.361
NH$337.111
NJ$353.99–$373.702
NM$304.271
NV$325.881
NY$311.23–$385.185
OH$302.331
OK$295.801
OR$323.93–$356.612
PA$303.44–$339.312
PR$329.301
RI$335.841
SC$304.681
SD$323.441
TN$299.181
TX$301.16–$341.948
UT$309.311
VA$320.35–$378.462
VI$329.301
VT$321.421
WA$340.52–$390.522
WI$311.721
WV$292.011
WY$325.201

See 78709 in every payment locality

How the 78709 rate is calculated

Each of 78709’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 · 78709

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense8.27

8.27 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

9.7700

Conversion factor

$33.4009

Medicare rate

$326.33

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,494

Code
78709
Physician work
1.37
Practice expense
8.27
Malpractice
0.13

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 78709 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense8.27× 0.9157.5671
Malpractice0.13× 0.3970.0516
Total RVUs8.9887
Conversion factor× 33.4009

Office rate, Iowa$300.23

Office: (1.37 × 1 + 8.27 × 0.915 + 0.13 × 0.397) × $33.4009 = $300.23

Open 78709 in the RVU calculator

Payment rules and modifiers for 78709

The CMS indicators that decide how 78709 is paid alongside other services.

CMS payment indicators · 78709

Renal imaging, multiple flow and function studies

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

78709 without 26 · national office

$326.33

Renal imaging, multiple flow and function studies

78709-26 · Professional component

$63.13

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78709

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

Codes related to 78709
CodeHow it relatesOffice range, Iowa
Same family
78707Renal imaging, single study, no drugSingle renal flow and function study without pharmacological intervention.$192.73
78708Renal imaging, pharmacologic interventionSingle renal flow and function study with pharmacological intervention.$159.15
Used instead
78701Kidney imaging, with vascular flowKidney morphology imaging with vascular flow, rather than multiple flow and function studies.$185.97
78725Kidney function study, quantitative clearanceEvaluates renal function without imaging.$91.09

How 78709 has changed in Iowa

78709 · Office / nonfacility

$300.23

Effective 2026-10-01

The base rate is $4.19 higher than on 2025-10-01, moving from $296.04 to $300.23 (1.4%).

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

    $296.04changed to$300.23

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.41 changed to 1.37
    • Practice expense RVU 8.43 changed to 8.27
    • Malpractice RVU 0.10 changed to 0.13
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $310.13changed to$296.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.60 changed to 8.43
    • Malpractice RVU 0.12 changed to 0.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $305.07changed to$310.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $321.25changed to$305.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.81 changed to 8.60
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $331.17changed to$321.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.94 changed to 8.81
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $345.01changed to$331.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.30 changed to 8.94
    • Malpractice RVU 0.10 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $346.69changed to$345.01

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.99 changed to 9.30
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $349.29changed to$346.69

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.08 changed to 8.99
    • Malpractice RVU 0.11 changed to 0.10
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $353.48changed to$349.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.22 changed to 9.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $348.29changed to$353.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.14 changed to 9.22
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $343.40changed to$348.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.07 changed to 9.14
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $341.38changed to$343.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.98 changed to 9.07
    • Malpractice RVU 0.09 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $339.69changed to$341.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $337.24changed to$339.69

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.92 changed to 8.98
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $339.54changed to$337.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.61 changed to 8.92
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $339.54

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$300.23Not available in this settingRVU26D
2026-07-01$300.23Not available in this settingRVU26C
2026-04-01$300.23Not available in this settingRVU26B
2026-01-01$300.23Not available in this settingRVU26A
2025-10-01$296.04Not available in this settingRVU25D
2025-07-01$296.04Not available in this settingRVU25C
2025-04-01$296.04Not available in this settingRVU25B
2025-01-01$296.04Not available in this settingRVU25A
2024-10-01$310.13Not available in this settingRVU24D
2024-07-01$310.13Not available in this settingRVU24C
2024-04-01$310.13Not available in this settingRVU24B
2024-03-09$310.13Not available in this settingRVU24AR
2024-01-01$305.07Not available in this settingRVU24A
2023-10-01$321.25Not available in this settingRVU23D
2023-07-01$321.25Not available in this settingRVU23C
2023-04-01$321.25Not available in this settingRVU23B
2023-01-01$321.25Not available in this settingRVU23A
2022-10-01$331.17Not available in this settingRVU22D
2022-07-01$331.17Not available in this settingRVU22C
2022-04-01$331.17Not available in this settingRVU22B
2022-01-01$331.17Not available in this settingRVU22A
2021-10-01$345.01Not available in this settingRVU21D
2021-07-01$345.01Not available in this settingRVU21C
2021-04-01$345.01Not available in this settingRVU21B
2021-01-01$345.01Not available in this settingRVU21A
2020-10-01$346.69Not available in this settingRVU20D
2020-07-01$346.69Not available in this settingRVU20C
2020-04-01$346.69Not available in this settingRVU20B
2020-01-01$346.69Not available in this settingRVU20A
2019-10-01$349.29Not available in this settingRVU19D
2019-07-01$349.29Not available in this settingRVU19C
2019-04-01$349.29Not available in this settingRVU19B
2019-01-01$349.29Not available in this settingRVU19A
2018-10-01$353.48Not available in this settingRVU18D
2018-07-01$353.48Not available in this settingRVU18C
2018-04-01$353.48Not available in this settingRVU18B
2018-01-01$353.48Not available in this settingRVU18AR1
2017-10-01$348.29Not available in this settingRVU17D
2017-07-01$348.29Not available in this settingRVU17C
2017-04-01$348.29Not available in this settingRVU17B
2017-01-01$348.29Not available in this settingRVU17A
2016-10-01$343.40Not available in this settingRVU16D
2016-07-01$343.40Not available in this settingRVU16C
2016-04-01$343.40Not available in this settingRVU16B
2016-01-01$343.40Not available in this settingRVU16A
2015-10-01$341.38Not available in this settingRVU15D
2015-07-01$341.38Not available in this settingRVU15C
2015-04-01$339.69Not available in this settingRVU15B
2015-01-01$339.69Not available in this settingRVU15A
2014-10-01$337.24Not available in this settingRVU14D
2014-07-01$337.24Not available in this settingRVU14C
2014-04-01$337.24Not available in this settingRVU14B
2014-01-01$337.24Not available in this settingRVU14A
2013-10-01$339.54Not available in this settingRVU13D
2013-07-01$339.54Not available in this settingRVU13C
2013-04-01$339.54Not available in this settingRVU13B
2013-01-01$339.54Not available in this settingRVU13AR

Price 78709 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

78709 billing questions

How is this different from a single renal flow and function study?

This code is for multiple renal flow and function studies. A single study without pharmacological intervention is described by 78707, while a single study with pharmacological intervention is described by 78708.

Do multiple images or views qualify as multiple studies?

Not by themselves. The documentation should identify multiple studies or protocols, rather than merely multiple images acquired as part of one study.

How should the professional and technical portions be billed?

Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Report the code without either modifier when billing the global service.

What documentation supports reporting this code?

Document the renal flow and function protocols performed, the findings for each study, and why the service involved multiple studies rather than one study with multiple images.

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 78709PPRRVU2026_Oct_nonQPP.csv, line 9,494 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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