CPT code 78811: PET imaging, limited area2026 Medicare rate & RVUs in New Mexico
Limited-area PET imaging uses radiotracer uptake to evaluate a focused body region, commonly for oncologic assessment, when broader coverage is not needed.
CMS doesn’t publish a rate for 78811 in New Mexico.
Check a contract rate as a % of Medicare · 78811 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How New Mexico compares for 78811
- New Mexico · this pageUnavailable
- Los Angeles, CA · CaliforniaUnavailable
- Washington, DC area · District of ColumbiaUnavailable
- Miami, FL · FloridaUnavailable
- Chicago, IL · IllinoisUnavailable
- Manhattan, NY · New YorkUnavailable
- Alaska · AlaskaUnavailable
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
78811 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 78811 has changed in New Mexico
78811 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Contractor-priced | Contractor-priced | RVU26D |
| 2026-07-01 | Contractor-priced | Contractor-priced | RVU26C |
| 2026-04-01 | Contractor-priced | Contractor-priced | RVU26B |
| 2026-01-01 | Contractor-priced | Contractor-priced | RVU26A |
| 2025-10-01 | Contractor-priced | Contractor-priced | RVU25D |
| 2025-07-01 | Contractor-priced | Contractor-priced | RVU25C |
| 2025-04-01 | Contractor-priced | Contractor-priced | RVU25B |
| 2025-01-01 | Contractor-priced | Contractor-priced | RVU25A |
| 2024-10-01 | Contractor-priced | Contractor-priced | RVU24D |
| 2024-07-01 | Contractor-priced | Contractor-priced | RVU24C |
| 2024-04-01 | Contractor-priced | Contractor-priced | RVU24B |
| 2024-03-09 | Contractor-priced | Contractor-priced | RVU24AR |
| 2024-01-01 | Contractor-priced | Contractor-priced | RVU24A |
| 2023-10-01 | Contractor-priced | Contractor-priced | RVU23D |
| 2023-07-01 | Contractor-priced | Contractor-priced | RVU23C |
| 2023-04-01 | Contractor-priced | Contractor-priced | RVU23B |
| 2023-01-01 | Contractor-priced | Contractor-priced | RVU23A |
| 2022-10-01 | Contractor-priced | Contractor-priced | RVU22D |
| 2022-07-01 | Contractor-priced | Contractor-priced | RVU22C |
| 2022-04-01 | Contractor-priced | Contractor-priced | RVU22B |
| 2022-01-01 | Contractor-priced | Contractor-priced | RVU22A |
| 2021-10-01 | Contractor-priced | Contractor-priced | RVU21D |
| 2021-07-01 | Contractor-priced | Contractor-priced | RVU21C |
| 2021-04-01 | Contractor-priced | Contractor-priced | RVU21B |
| 2021-01-01 | Contractor-priced | Contractor-priced | RVU21A |
| 2020-10-01 | Contractor-priced | Contractor-priced | RVU20D |
| 2020-07-01 | Contractor-priced | Contractor-priced | RVU20C |
| 2020-04-01 | Contractor-priced | Contractor-priced | RVU20B |
| 2020-01-01 | Contractor-priced | Contractor-priced | RVU20A |
| 2019-10-01 | Contractor-priced | Contractor-priced | RVU19D |
| 2019-07-01 | Contractor-priced | Contractor-priced | RVU19C |
| 2019-04-01 | Contractor-priced | Contractor-priced | RVU19B |
| 2019-01-01 | Contractor-priced | Contractor-priced | RVU19A |
| 2018-10-01 | Contractor-priced | Contractor-priced | RVU18D |
| 2018-07-01 | Contractor-priced | Contractor-priced | RVU18C |
| 2018-04-01 | Contractor-priced | Contractor-priced | RVU18B |
| 2018-01-01 | Contractor-priced | Contractor-priced | RVU18AR1 |
| 2017-10-01 | Contractor-priced | Contractor-priced | RVU17D |
| 2017-07-01 | Contractor-priced | Contractor-priced | RVU17C |
| 2017-04-01 | Contractor-priced | Contractor-priced | RVU17B |
| 2017-01-01 | Contractor-priced | Contractor-priced | RVU17A |
| 2016-10-01 | Contractor-priced | Contractor-priced | RVU16D |
| 2016-07-01 | Contractor-priced | Contractor-priced | RVU16C |
| 2016-04-01 | Contractor-priced | Contractor-priced | RVU16B |
| 2016-01-01 | Contractor-priced | Contractor-priced | RVU16A |
| 2015-10-01 | Contractor-priced | Contractor-priced | RVU15D |
| 2015-07-01 | Contractor-priced | Contractor-priced | RVU15C |
| 2015-04-01 | Contractor-priced | Contractor-priced | RVU15B |
| 2015-01-01 | Contractor-priced | Contractor-priced | RVU15A |
| 2014-10-01 | Contractor-priced | Contractor-priced | RVU14D |
| 2014-07-01 | Contractor-priced | Contractor-priced | RVU14C |
| 2014-04-01 | Contractor-priced | Contractor-priced | RVU14B |
| 2014-01-01 | Contractor-priced | Contractor-priced | RVU14A |
| 2013-10-01 | Contractor-priced | Contractor-priced | RVU13D |
| 2013-07-01 | Contractor-priced | Contractor-priced | RVU13C |
| 2013-04-01 | Contractor-priced | Contractor-priced | RVU13B |
| 2013-01-01 | Contractor-priced | Contractor-priced | RVU13AR |
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
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
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