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CPT code 78813: Whole-body PET, without CT2026 Medicare rate & RVUs

Reports whole-body positron emission tomography without CT when diagnostic imaging covers the full body rather than a limited area or skull-to-thigh range.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.2K Medicare services in 2024

Medicare rate · 78813

Whole-body PET, without CT

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 78813 →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 78813 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 78813 covers

Code 78813 identifies a diagnostic positron emission tomography (PET) study covering the whole body. The coverage extent distinguishes it from limited-area PET imaging and PET imaging covering the skull through the thighs. Code 78816 is the corresponding whole-body PET service that includes CT. The service includes PET image acquisition and interpretation; its professional and technical work can be identified separately.

Medicare assigns status C, carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Modifier 26 identifies professional interpretation, while modifier TC identifies equipment and staff. Reporting 78813 without either modifier represents the global service. Choose among PET codes according to the imaged extent and whether the examination includes CT.

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 78813 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

78813 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

78813 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
78813 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 78813 rate is calculated

Each of 78813’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 · 78813

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 78813

The CMS indicators that decide how 78813 is paid alongside other services.

CMS payment indicators · 78813

Whole-body PET, without CT

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

78813 without 26 · national facility

$0.00

Whole-body PET, without CT

78813-26 · Professional component

$88.51

Pays only the interpretation and report.

When to use modifier 26

78813 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78813

    Whole-body PET, without CT0 wRVU

    Not priced

  • 78811

    PET imaging, limited area0 wRVU

    Not priced

  • 78812

    PET imaging, skull base to mid-thigh0 wRVU

    Not priced

  • 78816

    PET/CT imaging, whole body0 wRVU

    Not priced

How to choose

78811PET imagingLimited area
Use 78811 for limited-area PET coverage; 78813 describes whole-body coverage.
78812PET imagingSkull base to mid-thigh
78812 covers the skull through the thighs, while 78813 describes whole-body PET imaging.
78816PET/CT imagingWhole body
Both describe whole-body PET coverage, but 78816 includes CT.

Codes related to 78813

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

Codes related to 78813
CodeHow it relatesNational office range
Same family
78811PET imaging, limited areaPET imaging with limited-area coverage.No office rate
78812PET imaging, skull base to mid-thighPET imaging covering the skull through the thighs.No office rate
Used instead
78816PET/CT imaging, whole bodyWhole-body PET imaging that includes CT.No office rate
78815PET/CT imaging, skull base to mid-thighPET imaging with CT covering the skull through the thighs.No office rate

78813 billing questions

How does 78813 differ from 78812?

78813 describes whole-body PET imaging. 78812 describes PET imaging covering the skull through the thighs.

When is 78816 used instead?

78816 describes whole-body PET imaging that includes CT. Use 78813 for whole-body PET imaging without CT.

Which modifiers identify the components?

Modifier 26 identifies professional interpretation, and modifier TC identifies equipment and staff. Reporting the code without either modifier represents the global service.

How does Medicare price this code?

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

Which code describes limited-area PET imaging?

78811 describes limited-area PET imaging; 78813 describes whole-body PET 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

Open CMS sourceHow we calculate rates

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