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CPT code 78816: PET/CT imaging, whole body2026 Medicare rate & RVUs

Whole-body PET/CT combines radiotracer-based imaging with CT anatomy to assess disease extent, commonly for cancer staging or restaging.

CMS RVU26DEffective Oct 1, 2026109 payment localities118.6K Medicare services in 2024

Medicare rate · 78816

PET/CT imaging, whole body

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 78816 →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 78816 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 78816 covers

This service combines PET imaging, which shows radiotracer activity in the body, with CT images that provide anatomic detail. It is used when a whole-body examination is needed, including for cancer staging, restaging, or assessment of disease extent. Nuclear medicine and radiology departments typically perform the scan; a qualified clinician interprets the images. The code distinguishes a whole-body PET/CT examination from limited-area and skull-to-thigh studies.

Medicare assigns this CPT code physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The professional interpretation may be reported with modifier 26, and the technical service with modifier TC; without either modifier, the code represents 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.

Where 78816 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

78816 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

78816 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
78816 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 78816 rate is calculated

Each of 78816’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 · 78816

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 78816

The CMS indicators that decide how 78816 is paid alongside other services.

CMS payment indicators · 78816

PET/CT imaging, whole body

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

78816 without 26 · national facility

$0.00

PET/CT imaging, whole body

78816-26 · Professional component

$111.22

Pays only the interpretation and report.

When to use modifier 26

78816 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 78816

    PET/CT imaging, whole body0 wRVU

    Not priced

  • 78813

    Whole-body PET, without CT0 wRVU

    Not priced

  • 78815

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

    Not priced

  • 78814

    PET with CT, limited area0 wRVU

    Not priced

  • 78812

    PET imaging, skull base to mid-thigh0 wRVU

    Not priced

How to choose

78813Whole-body PETWithout CT
Both describe whole-body PET imaging, but 78816 includes CT while 78813 describes PET without CT.
78815PET/CT imagingSkull base to mid-thigh
78815 describes PET/CT from the skull to the mid-thigh; 78816 is used for whole-body PET/CT.
78814PET with CTLimited area
78814 is for limited-area PET/CT. Use 78816 when the examination covers the whole body.
78812PET imagingSkull base to mid-thigh
78812 describes skull-to-thigh PET imaging without CT, unlike the whole-body PET/CT service represented by 78816.

Codes related to 78816

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

Codes related to 78816
CodeHow it relatesNational office range
Used instead
78813Whole-body PET, without CTWhole-body PET imaging without the CT component.No office rate
78815PET/CT imaging, skull base to mid-thighPET/CT examination covering the skull-to-mid-thigh range.No office rate
78814PET with CT, limited areaPET/CT imaging of a limited area rather than the whole body.No office rate
78812PET imaging, skull base to mid-thighSkull-to-thigh PET imaging without CT.No office rate

78816 billing questions

How does this differ from 78815?

78816 represents whole-body PET/CT imaging. 78815 is for PET/CT imaging from the skull to the mid-thigh, so select according to the examination extent.

When would 78813 be used instead?

78813 describes whole-body PET imaging without CT. Use 78816 when the whole-body PET examination is performed with CT.

Can the professional and technical services be reported separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, 78816 represents the global service.

How does Medicare set payment for 78816?

The physician fee schedule status is carrier priced (status C). CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.

Should 78816 be reported for a limited-area PET/CT?

No. 78816 is for a whole-body examination; 78814 describes limited-area PET/CT 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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