CPT code 78813: Whole-body PET, without CT2026 Medicare rate & RVUs in Oregon
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 doesn’t publish an office rate for 78813 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | Unavailable |
| Rest of Oregon | Unavailable | Unavailable |
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
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
| 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
78813 without 26 · national facility
$0.00
Whole-body PET, without CT
78813-26 · Professional component
$88.51
Pays only the interpretation and report.
78813 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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