CPT code 78801: Tumor imaging, two or more areas, one day2026 Medicare rate & RVUs in California

Reports one-day radiopharmaceutical tumor-localization imaging covering two or more areas, such as when a nuclear medicine study evaluates multiple suspected tumor sites.

CMS RVU26DEffective Oct 1, 202629 payment localities838 Medicare services in 2024

Medicare pays $259.84–$336.01 for 78801 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

$259.84–$336.01Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 78801 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 78801 covers

This nuclear medicine study uses a radioactive tracer to produce images that help locate tumor tissue in two or more areas during one day of imaging. A nuclear medicine technologist typically performs the acquisition in a hospital or imaging center, and a radiologist or nuclear medicine physician interprets the study. The selected code reflects the extent and timing of the imaging, not the number of lesions found.

Document the clinical indication, radiopharmaceutical used, areas imaged, imaging date, and interpretation. Report one service for the two-or-more-area, one-day study; the code is not selected per lesion. It is a diagnostic test with separately identifiable professional and technical components: modifier 26 reports interpretation, modifier TC reports equipment and staff, and no component modifier represents the global service. Radiopharmaceutical injection may be separately represented by 78808 when applicable.

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 78801 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 payment localities

$259.84 to $336.01

$259.84$297.92$336.01
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

29 of 29 payment localities

78801 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CA$260.08Unavailable
Chico, CA$259.84Unavailable
El Centro, CA$259.85Unavailable
Fresno, CA$259.84Unavailable
Hanford, CA$259.84Unavailable
Los Angeles, CA$279.35Unavailable
Madera, CA$259.84Unavailable
Marin County, CA$328.60Unavailable
Merced, CA$259.84Unavailable
Modesto, CA$259.84Unavailable

How the 78801 rate is calculated

Each of 78801’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 · 78801

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.71

0.71 RVUs× 1.000 GPCI

Practice expense6.40

6.40 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

7.1900

Conversion factor

$33.4009

Medicare rate

$240.15

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

Payment rules and modifiers for 78801

The CMS indicators that decide how 78801 is paid alongside other services.

CMS payment indicators · 78801

Tumor imaging, two or more areas, one day

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

78801 without 26 · national office

$240.15

Tumor imaging, two or more areas, one day

78801-26 · Professional component

$33.07

Pays only the interpretation and report.

When to use modifier 26

78801 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 78801

    Tumor imaging, two or more areas, one day0.71 wRVU

    $240.15

  • 78800

    Tumor imaging, single area, one day0.62 wRVU

    $231.80−$8.35

  • 78802

    Tumor imaging, whole body, single day0.78 wRVU

    $270.21+$30.06

  • 78804

    Tumor localization, whole body, two or more days0.98 wRVU

    $561.14+$320.99

  • 78831

    Tumor SPECT, two or more areas1.77 wRVU

    $622.93+$382.78

How to choose

78800Tumor imagingSingle area, one day
Use 78800 for one imaged area during one day; use 78801 when two or more areas are imaged that day.
78802Tumor imagingWhole body, single day
78802 describes whole-body tumor localization with one-day imaging. 78801 describes two or more areas rather than a whole-body study.
78804Tumor localizationWhole body, two or more days
78804 is for whole-body imaging performed over two or more days; 78801 is for two or more areas imaged in one day.
78831Tumor SPECTTwo or more areas
78831 is the SPECT study for two or more areas. Choose 78801 when the study is not reported as SPECT.

78801 billing questions

When should 78801 be selected instead of 78800?

Use 78801 when tumor-localization imaging covers two or more areas in one day. Code 78800 describes one area with one-day imaging.

Does this code include radiopharmaceutical administration?

The imaging code describes the localization study. Code 78808 represents injection for a diagnostic radiopharmaceutical study and may be reported with it when applicable.

How are the professional and technical services billed?

Use modifier 26 for the interpretation and report, or modifier TC for the equipment and staff. Report the service without either modifier when billing globally.

What documentation supports reporting two or more areas?

The record should identify the areas imaged, the study date, the radiopharmaceutical, the indication, and the interpreting physician’s findings. It should support imaging of at least two areas during the one-day study.

How does 78801 differ from whole-body imaging?

78801 is for two or more areas imaged in one day. Whole-body studies use the whole-body codes, with 78804 identifying imaging over two or more days.

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 78801PPRRVU2026_Oct_nonQPP.csv, line 9,515 (RVU26D)

Open CMS sourceHow we calculate rates

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