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

CMS doesn’t publish an office rate for 78816 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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 in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

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.

Payment rules and modifiers for 78816

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

What modifiers do to the payment

When to use modifier 26

78816 compared with similar codes

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.

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