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

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, 2026One payment locality838 Medicare services in 2024

In Puerto Rico, Medicare pays $242.46 for 78801 in the office.

$242.46Office (non-facility)
Not available in this settingHospital or facility
+1.0%vs the national office rate ($240.15)

Check a contract rate as a % of Medicare · 78801 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 78801 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 78801 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 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.

How Puerto Rico compares for 78801

Across 109 of 109 payment localities, the office rate for 78801 runs from $208.72 in Arkansas to $336.01 in San Benito County, CA. Puerto Rico pays $242.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

78801 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$242.46
  2. Los Angeles, CA · California$279.35+$36.89
  3. Washington, DC area · District of Columbia$279.79+$37.33
  4. Miami, FL · Florida$253.00+$10.54
  5. Chicago, IL · Illinois$244.85+$2.39
  6. Manhattan, NY · New York$277.87+$35.41
  7. Alaska · Alaska$264.70+$22.24

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

Every other payment area

78801 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$212.27—
ArkansasArkansas$208.72—
ArizonaArizona$233.14—
Bakersfield, CACalifornia$260.08—
Chico, CACalifornia$259.84—
El Centro, CACalifornia$259.85—
Fresno, CACalifornia$259.84—
Hanford, CACalifornia$259.84—

78801 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.

$208.72

$297.92

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

View every state and territory as a table
78801 office rate range by state
State / territoryOffice rate rangeLocalities
AK$264.701
AL$212.271
AR$208.721
AZ$233.141
CA$259.84–$336.0129
CO$253.531
CT$257.651
DC$279.791
DE$237.441
FL$232.09–$253.003
GA$217.58–$244.182
GU$268.311
HI$268.311
IA$220.371
ID$221.641
IL$223.06–$248.154
IN$223.171
KS$218.311
KY$216.201
LA$215.46–$227.902
MA$251.32–$282.302
MD$242.74–$279.793
ME$222.04–$237.242
MI$221.90–$234.502
MN$244.471
MO$210.58–$229.903
MS$209.741
MT$240.151
NC$224.871
ND$238.571
NE$222.031
NH$248.581
NJ$261.03–$276.032
NM$222.951
NV$239.921
NY$228.67–$284.365
OH$221.581
OK$216.681
OR$238.50–$263.582
PA$222.48–$249.862
PR$242.461
RI$247.371
SC$223.511
SD$238.381
TN$219.461
TX$220.72–$252.298
UT$227.051
VA$235.73–$279.792
VI$242.461
VT$236.691
WA$251.15–$289.372
WI$229.331
WV$213.301
WY$239.461

See 78801 in every payment locality

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,515

Code
78801
Physician work
0.71
Practice expense
6.40
Malpractice
0.08

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 78801 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.71× 1.0000.7100
Practice expense6.40× 1.0116.4704
Malpractice0.08× 0.9850.0788
Total RVUs7.2592
Conversion factor× 33.4009

Office rate, Puerto Rico$242.46

Office: (0.71 × 1 + 6.4 × 1.011 + 0.08 × 0.985) × $33.4009 = $242.46

Open 78801 in the RVU calculator

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

Codes related to 78801

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

Codes related to 78801
CodeHow it relatesOffice range, Puerto Rico
Same family
78800Tumor imaging, single area, one dayTumor localization for one area with one-day imaging.$234.04
78802Tumor imaging, whole body, single dayWhole-body tumor localization with one-day imaging.$272.83
78804Tumor localization, whole body, two or more daysWhole-body tumor localization with imaging over two or more days.$566.83
Often billed with
78808Radiopharmaceutical injection, diagnostic intravenous administrationReports injection for a diagnostic radiopharmaceutical study when applicable.$41.44
Used instead
78831Tumor SPECT, two or more areasTumor localization using SPECT for two or more areas.$628.99

How 78801 has changed in Puerto Rico

78801 · Office / nonfacility

$242.46

Effective 2026-10-01

The base rate is $4.25 higher than on 2025-10-01, moving from $238.21 to $242.46 (1.8%).

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

    $238.21changed to$242.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.73 changed to 0.71
    • Practice expense RVU 6.52 changed to 6.40
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $250.16changed to$238.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.66 changed to 6.52
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $246.08changed to$250.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $261.05changed to$246.08

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.84 changed to 6.66
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $259.24changed to$261.05

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $271.82changed to$259.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.99 changed to 6.84
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $292.01changed to$271.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.49 changed to 6.99
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $295.47changed to$292.01

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.30 changed to 7.49
    • Malpractice RVU 0.10 changed to 0.09
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $269.03changed to$295.47

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 0.79 changed to 0.73
    • Practice expense RVU 6.54 changed to 7.30
    • Malpractice RVU 0.09 changed to 0.10
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $275.62changed to$269.03

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.73 changed to 6.54

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $239.25changed to$275.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.79 changed to 6.73
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $198.71changed to$239.25

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.71 changed to 6.79
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $198.45changed to$198.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.68 changed to 6.71
    • Malpractice RVU 0.08 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $197.47changed to$198.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $184.66changed to$197.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.28 changed to 6.68
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $177.64changed to$184.66

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.51 changed to 6.28
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $177.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$242.46Not available in this settingRVU26D
2026-07-01$242.46Not available in this settingRVU26C
2026-04-01$242.46Not available in this settingRVU26B
2026-01-01$242.46Not available in this settingRVU26A
2025-10-01$238.21Not available in this settingRVU25D
2025-07-01$238.21Not available in this settingRVU25C
2025-04-01$238.21Not available in this settingRVU25B
2025-01-01$238.21Not available in this settingRVU25A
2024-10-01$250.16Not available in this settingRVU24D
2024-07-01$250.16Not available in this settingRVU24C
2024-04-01$250.16Not available in this settingRVU24B
2024-03-09$250.16Not available in this settingRVU24AR
2024-01-01$246.08Not available in this settingRVU24A
2023-10-01$261.05Not available in this settingRVU23D
2023-07-01$259.24Not available in this settingRVU23C
2023-04-01$259.24Not available in this settingRVU23B
2023-01-01$259.24Not available in this settingRVU23A
2022-10-01$271.82Not available in this settingRVU22D
2022-07-01$271.82Not available in this settingRVU22C
2022-04-01$271.82Not available in this settingRVU22B
2022-01-01$271.82Not available in this settingRVU22A
2021-10-01$292.01Not available in this settingRVU21D
2021-07-01$292.01Not available in this settingRVU21C
2021-04-01$292.01Not available in this settingRVU21B
2021-01-01$292.01Not available in this settingRVU21A
2020-10-01$295.47Not available in this settingRVU20D
2020-07-01$295.47Not available in this settingRVU20C
2020-04-01$295.47Not available in this settingRVU20B
2020-01-01$295.47Not available in this settingRVU20A
2019-10-01$269.03Not available in this settingRVU19D
2019-07-01$269.03Not available in this settingRVU19C
2019-04-01$269.03Not available in this settingRVU19B
2019-01-01$269.03Not available in this settingRVU19A
2018-10-01$275.62Not available in this settingRVU18D
2018-07-01$275.62Not available in this settingRVU18C
2018-04-01$275.62Not available in this settingRVU18B
2018-01-01$275.62Not available in this settingRVU18AR1
2017-10-01$239.25Not available in this settingRVU17D
2017-07-01$239.25Not available in this settingRVU17C
2017-04-01$239.25Not available in this settingRVU17B
2017-01-01$239.25Not available in this settingRVU17A
2016-10-01$198.71Not available in this settingRVU16D
2016-07-01$198.71Not available in this settingRVU16C
2016-04-01$198.71Not available in this settingRVU16B
2016-01-01$198.71Not available in this settingRVU16A
2015-10-01$198.45Not available in this settingRVU15D
2015-07-01$198.45Not available in this settingRVU15C
2015-04-01$197.47Not available in this settingRVU15B
2015-01-01$197.47Not available in this settingRVU15A
2014-10-01$184.66Not available in this settingRVU14D
2014-07-01$184.66Not available in this settingRVU14C
2014-04-01$184.66Not available in this settingRVU14B
2014-01-01$184.66Not available in this settingRVU14A
2013-10-01$177.64Not available in this settingRVU13D
2013-07-01$177.64Not available in this settingRVU13C
2013-04-01$177.64Not available in this settingRVU13B
2013-01-01$177.64Not available in this settingRVU13AR

Price 78801 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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