CPT code 78804: Tumor localization, whole body, two or more days2026 Medicare rate & RVUs

Medicare pays $561.14 for 78804 nationally in the office. Local office rates run $485.14–$794.36.

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

What 78804 covers

This code represents a nuclear medicine tumor-localization study in which a radiopharmaceutical is used to identify tumor-related activity throughout the body, with imaging performed on at least two days. Nuclear medicine technologists acquire the images, and a qualified physician interprets them. The service is typically performed in a hospital or outpatient nuclear medicine department when the diagnostic protocol calls for delayed or serial whole-body imaging rather than a single-day acquisition.

Select the code based on whole-body coverage and the multi-day imaging protocol, not simply the number of images. Documentation should identify the clinical indication, radiopharmaceutical, body coverage, imaging dates or timepoints, and the physician’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff portion, or neither modifier for the global service.

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 78804 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

78804 rates by state

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

How the 78804 rate is calculated

Each of 78804’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.

Payment rules and modifiers for 78804

The CMS indicators that decide how 78804 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78804 compared with similar codes

How to choose

78802Tumor imagingWhole body, single day

Both describe whole-body tumor-localization imaging. Choose 78804 when imaging spans two or more days and 78802 when the study is performed on one day.

78800Tumor imagingSingle area, one day

78800 is for one body area; 78804 is for whole-body imaging performed over two or more days.

78803Tumor SPECTSingle body area

78803 identifies SPECT tumor-localization imaging. Choose 78804 for a multi-day whole-body study when the service is not reported as the SPECT procedure.

Codes related to 78804

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

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

Open CMS sourceHow we calculate rates