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

Reports whole-body radiopharmaceutical tumor-localization imaging when image acquisition extends across two or more days for the diagnostic study.

CMS RVU26DEffective Oct 1, 2026One payment locality807 Medicare services in 2024

In New Mexico, Medicare pays $518.51 for 78804 in the office.

$518.51Office (non-facility)
Not available in this settingHospital or facility
−7.6%vs the national office rate ($561.14)

Check a contract rate as a % of Medicare · 78804 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 78804 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 78804 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 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.

How New Mexico compares for 78804

Across 109 of 109 payment localities, the office rate for 78804 runs from $485.14 in Arkansas to $794.36 in San Benito County, CA. New Mexico pays $518.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

78804 in New Mexico vs other payment areas
  1. New Mexico · this page$518.51
  2. Los Angeles, CA · California$656.92+$138.41
  3. Washington, DC area · District of Columbia$656.68+$138.17
  4. Miami, FL · Florida$589.26+$70.75
  5. Chicago, IL · Illinois$569.61+$51.10
  6. Manhattan, NY · New York$650.67+$132.16
  7. Alaska · Alaska$609.62+$91.11

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

Every other payment area

78804 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$493.74—
ArkansasArkansas$485.14—
ArizonaArizona$544.26—
Bakersfield, CACalifornia$610.37—
Chico, CACalifornia$609.99—
El Centro, CACalifornia$610.01—
Fresno, CACalifornia$609.99—
Hanford, CACalifornia$609.99—

78804 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.

$485.14

$702.18

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

View every state and territory as a table
78804 office rate range by state
State / territoryOffice rate rangeLocalities
AK$609.621
AL$493.741
AR$485.141
AZ$544.261
CA$609.99–$794.3629
CO$594.121
CT$603.051
DC$656.681
DE$554.571
FL$540.26–$589.263
GA$505.37–$570.492
GU$631.101
HI$631.101
IA$513.971
ID$516.921
IL$517.99–$578.874
IN$520.651
KS$508.671
KY$502.601
LA$500.69–$530.812
MA$588.55–$663.672
MD$567.40–$656.683
ME$517.57–$554.822
MI$516.10–$545.772
MN$573.281
MO$488.70–$535.993
MS$487.161
MT$561.131
NC$524.461
ND$558.561
NE$518.081
NH$582.081
NJ$611.08–$647.342
NM$518.511
NV$560.931
NY$533.64–$666.005
OH$515.581
OK$504.091
OR$557.75–$618.722
PA$517.92–$584.052
PR$566.831
RI$578.581
SC$520.661
SD$558.251
TN$511.441
TX$513.66–$591.108
UT$529.251
VA$550.95–$656.682
VI$566.831
VT$553.751
WA$588.30–$680.942
WI$536.121
WV$494.351
WY$560.011

See 78804 in every payment locality

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.

How the rate is built · 78804

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense15.69

15.69 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

16.8000

Conversion factor

$33.4009

Medicare rate

$561.14

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,524

Code
78804
Physician work
0.98
Practice expense
15.69
Malpractice
0.13

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 78804 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense15.69× 0.91714.3877
Malpractice0.13× 1.2010.1561
Total RVUs15.5239
Conversion factor× 33.4009

Office rate, New Mexico$518.51

Office: (0.98 × 1 + 15.69 × 0.917 + 0.13 × 1.201) × $33.4009 = $518.51

Open 78804 in the RVU calculator

Payment rules and modifiers for 78804

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

CMS payment indicators · 78804

Tumor localization, whole body, two or more days

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

78804 without 26 · national office

$561.14

Tumor localization, whole body, two or more days

78804-26 · Professional component

$45.09

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78804

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

Codes related to 78804
CodeHow it relatesOffice range, New Mexico
Same family
78800Tumor imaging, single area, one dayTumor-localization imaging of one area, distinguished by limited body coverage.$215.23
78801Tumor imaging, two or more areas, one dayTumor-localization imaging of multiple areas, distinguished from whole-body coverage.$222.95
78802Tumor imaging, whole body, single dayWhole-body tumor-localization imaging completed on one day.$250.71
78803Tumor SPECT, single body areaSPECT tumor-localization imaging, distinguished by imaging technique.$311.70

How 78804 has changed in New Mexico

78804 · Office / nonfacility

$518.51

Effective 2026-10-01

The base rate is $12.54 higher than on 2025-10-01, moving from $505.97 to $518.51 (2.5%).

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

    $505.97changed to$518.51

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.01 changed to 0.98
    • Practice expense RVU 15.96 changed to 15.69
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $535.68changed to$505.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 16.43 changed to 15.96
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $526.94changed to$535.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $555.55changed to$526.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 16.90 changed to 16.43
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $578.48changed to$555.55

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 17.36 changed to 16.90
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $612.04changed to$578.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 18.28 changed to 17.36

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $623.22changed to$612.04

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 17.72 changed to 18.28
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $548.14changed to$623.22

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.07 changed to 1.01
    • Practice expense RVU 15.19 changed to 17.72
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $556.49changed to$548.14

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 15.46 changed to 15.19

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $551.07changed to$556.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 15.37 changed to 15.46
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $548.05changed to$551.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 15.34 changed to 15.37
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $550.60changed to$548.05

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 15.37 changed to 15.34
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $547.86changed to$550.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $535.48changed to$547.86

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 15.00 changed to 15.37
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $540.31changed to$535.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 16.06 changed to 15.00
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $540.31

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$518.51Not available in this settingRVU26D
2026-07-01$518.51Not available in this settingRVU26C
2026-04-01$518.51Not available in this settingRVU26B
2026-01-01$518.51Not available in this settingRVU26A
2025-10-01$505.97Not available in this settingRVU25D
2025-07-01$505.97Not available in this settingRVU25C
2025-04-01$505.97Not available in this settingRVU25B
2025-01-01$505.97Not available in this settingRVU25A
2024-10-01$535.68Not available in this settingRVU24D
2024-07-01$535.68Not available in this settingRVU24C
2024-04-01$535.68Not available in this settingRVU24B
2024-03-09$535.68Not available in this settingRVU24AR
2024-01-01$526.94Not available in this settingRVU24A
2023-10-01$555.55Not available in this settingRVU23D
2023-07-01$555.55Not available in this settingRVU23C
2023-04-01$555.55Not available in this settingRVU23B
2023-01-01$555.55Not available in this settingRVU23A
2022-10-01$578.48Not available in this settingRVU22D
2022-07-01$578.48Not available in this settingRVU22C
2022-04-01$578.48Not available in this settingRVU22B
2022-01-01$578.48Not available in this settingRVU22A
2021-10-01$612.04Not available in this settingRVU21D
2021-07-01$612.04Not available in this settingRVU21C
2021-04-01$612.04Not available in this settingRVU21B
2021-01-01$612.04Not available in this settingRVU21A
2020-10-01$623.22Not available in this settingRVU20D
2020-07-01$623.22Not available in this settingRVU20C
2020-04-01$623.22Not available in this settingRVU20B
2020-01-01$623.22Not available in this settingRVU20A
2019-10-01$548.14Not available in this settingRVU19D
2019-07-01$548.14Not available in this settingRVU19C
2019-04-01$548.14Not available in this settingRVU19B
2019-01-01$548.14Not available in this settingRVU19A
2018-10-01$556.49Not available in this settingRVU18D
2018-07-01$556.49Not available in this settingRVU18C
2018-04-01$556.49Not available in this settingRVU18B
2018-01-01$556.49Not available in this settingRVU18AR1
2017-10-01$551.07Not available in this settingRVU17D
2017-07-01$551.07Not available in this settingRVU17C
2017-04-01$551.07Not available in this settingRVU17B
2017-01-01$551.07Not available in this settingRVU17A
2016-10-01$548.05Not available in this settingRVU16D
2016-07-01$548.05Not available in this settingRVU16C
2016-04-01$548.05Not available in this settingRVU16B
2016-01-01$548.05Not available in this settingRVU16A
2015-10-01$550.60Not available in this settingRVU15D
2015-07-01$550.60Not available in this settingRVU15C
2015-04-01$547.86Not available in this settingRVU15B
2015-01-01$547.86Not available in this settingRVU15A
2014-10-01$535.48Not available in this settingRVU14D
2014-07-01$535.48Not available in this settingRVU14C
2014-04-01$535.48Not available in this settingRVU14B
2014-01-01$535.48Not available in this settingRVU14A
2013-10-01$540.31Not available in this settingRVU13D
2013-07-01$540.31Not available in this settingRVU13C
2013-04-01$540.31Not available in this settingRVU13B
2013-01-01$540.31Not available in this settingRVU13AR

Price 78804 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

78804 billing questions

How does this differ from 78802?

78804 is for whole-body tumor-localization imaging performed over two or more days. Use 78802 when the whole-body study is completed on one day.

When should I choose 78800 or 78801 instead?

Those codes describe tumor-localization imaging of one area or multiple areas, rather than whole-body imaging. Choose according to the documented body coverage.

Can the professional and technical portions be billed separately?

Yes. Report modifier 26 for the physician’s interpretation or TC for the technical service; without either modifier, the claim represents the global service.

What documentation supports 78804?

Document the whole-body coverage, radiopharmaceutical, clinical indication, image-acquisition dates or timepoints, and the interpreting physician’s findings.

Is 78804 the right code for SPECT tumor imaging?

Use the applicable SPECT tumor-localization code when the service is SPECT-based. 78804 identifies a multi-day whole-body study, not SPECT imaging.

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 78804PPRRVU2026_Oct_nonQPP.csv, line 9,524 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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