CPT code 78800: Tumor imaging, single area, one day2026 Medicare rate & RVUs in Texas
Reports planar radiopharmaceutical imaging to localize a tumor in one body area when imaging is performed on a single day.
Medicare pays $212.87–$243.51 for 78800 in the office in Texas, from Beaumont, TX to Austin, TX. 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 78800 covers
This service covers planar nuclear medicine imaging after administration of a radiopharmaceutical to assess tumor location in one body area, such as a region of clinical concern in an oncology evaluation. A nuclear medicine technologist performs the acquisition, with interpretation by a qualified physician, commonly a radiologist or nuclear medicine physician. The study is selected when the examination covers one area and imaging occurs on one day, rather than multiple areas, whole-body imaging, or SPECT-based imaging.
The record should identify the clinical indication, radiopharmaceutical study, imaged area, acquisition method, and imaging date. Choose the code based on the study performed, not simply the number of images obtained. CMS recognizes separately priced professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier when billing the global service. The physician’s report should support the diagnostic interpretation of the acquired images.
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 78800 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$212.87 to $243.51
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $243.51 | Unavailable |
| Beaumont, TX | $212.87 | Unavailable |
| Brazoria, TX | $229.36 | Unavailable |
| Dallas, TX | $230.68 | Unavailable |
| Fort Worth, TX | $228.65 | Unavailable |
| Galveston, TX | $229.94 | Unavailable |
| Houston, TX | $231.77 | Unavailable |
| Rest of Texas | $220.88 | Unavailable |
How the 78800 rate is calculated
Each of 78800’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 · 78800
RVUs × geographic indexes × conversion factor
Work0.62
0.62 RVUs× 1.000 GPCI
Practice expense6.22
6.22 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
6.9400
Conversion factor
$33.4009
Medicare rate
$231.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78800
The CMS indicators that decide how 78800 is paid alongside other services.
CMS payment indicators · 78800
Tumor imaging, single area, one day
| 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
78800 without 26 · national office
$231.80
Tumor imaging, single area, one day
78800-26 · Professional component
$30.73
Pays only the interpretation and report.
78800 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78801Tumor imagingTwo or more areas, one day
- Choose 78800 when imaging is limited to one area on one day; 78801 covers multiple areas and permits imaging over one or more days.
- 78803Tumor SPECTSingle body area
- 78800 represents planar imaging of one area. Use 78803 when the tumor-localization acquisition is performed with SPECT.
- 78830Tumor SPECT/CTSingle imaging area
- 78830 describes SPECT tumor-localization imaging with CT for one area; 78800 is for planar imaging without that SPECT/CT approach.
78800 billing questions
How does this differ from 78801?
Use 78800 for imaging of one area on one day. Code 78801 describes imaging of multiple areas, with one or more days of imaging.
Can 78800 be used for SPECT imaging?
No. This code describes planar tumor-localization imaging. For SPECT of one area, consider 78803; SPECT with CT is represented by 78830.
Which modifier identifies the physician interpretation?
Append modifier 26 when billing only the professional component. Modifier TC identifies the technical component; billing without either modifier represents the global service.
What should the report document?
Document the tumor-localization indication, the single body area examined, the radiopharmaceutical imaging performed, and the imaging date. The physician report should support the interpretation.
Is radiopharmaceutical injection reported with this imaging code?
The injection procedure may be separately represented by 78808 when performed and supported by the record. Code 78800 represents the imaging service.
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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