CPT code 78816: PET/CT imaging, whole body2026 Medicare rate & RVUs in New Mexico
Whole-body PET/CT combines radiotracer-based imaging with CT anatomy to assess disease extent, commonly for cancer staging or restaging.
CMS doesn’t publish a rate for 78816 in New Mexico.
Check a contract rate as a % of Medicare · 78816 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 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.
How New Mexico compares for 78816
- 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
78816 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 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
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
| 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
78816 without 26 · national facility
$0.00
PET/CT imaging, whole body
78816-26 · Professional component
$111.22
Pays only the interpretation and report.
How 78816 has changed in New Mexico
78816 · 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
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
Fee sheets · Coming soon
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