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CPT code 78811: PET imaging, limited area2026 Medicare rate & RVUs

Limited-area PET imaging uses radiotracer uptake to evaluate a focused body region, commonly for oncologic assessment, when broader coverage is not needed.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare rate · 78811

PET imaging, limited area

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 78811 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 78811 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78811 covers

This service captures positron emission tomography images of a focused body region, such as the chest, head and neck, abdomen, or pelvis. A nuclear medicine or radiology imaging team performs the scan, and a qualified physician interprets it. PET imaging may be used to assess suspected or known disease, including cancer, in the area selected for the clinical question. This code describes PET imaging without the CT component represented by PET/CT codes.

Medicare lists 78811 with physician fee schedule status C, meaning there is no national payment amount and the Medicare Administrative Contractor sets payment for each claim. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff service, and no modifier represents the global service. The code represents one PET imaging study of a limited body area.

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 78811 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

78811 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

78811 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.

View every state and territory as a table
78811 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 78811 rate is calculated

Each of 78811’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 · 78811

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 78811

The CMS indicators that decide how 78811 is paid alongside other services.

CMS payment indicators · 78811

PET imaging, limited area

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

78811 without 26 · national facility

$0.00

PET imaging, limited area

78811-26 · Professional component

$68.81

Pays only the interpretation and report.

When to use modifier 26

78811 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 78811

    PET imaging, limited area0 wRVU

    Not priced

  • 78812

    PET imaging, skull base to mid-thigh0 wRVU

    Not priced

  • 78813

    Whole-body PET, without CT0 wRVU

    Not priced

  • 78814

    PET with CT, limited area0 wRVU

    Not priced

  • 78815

    PET/CT imaging, skull base to mid-thigh0 wRVU

    Not priced

How to choose

78812PET imagingSkull base to mid-thigh
78812 covers the skull-to-mid-thigh region. Choose 78811 when the PET study is limited to a smaller body area.
78813Whole-body PETWithout CT
78813 represents whole-body PET imaging; 78811 is for a limited area.
78814PET with CTLimited area
Both describe limited-area imaging, but 78814 includes CT and 78811 describes PET imaging without CT.
78815PET/CT imagingSkull base to mid-thigh
78815 combines PET and CT for skull-to-mid-thigh coverage. 78811 is limited-area PET imaging without CT.

Codes related to 78811

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

Codes related to 78811
CodeHow it relatesNational office range
Used instead
78812PET imaging, skull base to mid-thighPET imaging covering the skull to mid-thigh rather than a limited body area.No office rate
78813Whole-body PET, without CTPET imaging covering the whole body rather than a limited body area.No office rate
78814PET with CT, limited areaLimited-area PET imaging that includes CT.No office rate
78815PET/CT imaging, skull base to mid-thighPET/CT imaging covering the skull to mid-thigh.No office rate
78816PET/CT imaging, whole bodyPET/CT imaging covering the whole body.No office rate

78811 billing questions

When should 78811 be chosen over 78812 or 78813?

Use 78811 for PET imaging of a limited body area. Codes 78812 and 78813 represent broader coverage: skull to mid-thigh and whole body, respectively.

How does 78811 differ from 78814?

78811 describes PET imaging without CT. Use 78814 when the limited-area study includes CT.

How are the professional and technical services reported?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the code represents the global service.

How many units are reported?

Report one unit for one limited-area PET imaging study.

How does Medicare price 78811?

Its physician fee schedule status is C, or carrier priced. The Medicare Administrative Contractor sets payment for each claim; CMS publishes no national payment amount.

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

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