Billing code 78258: Esophageal motilityMedicare rate & RVUs
Reports radionuclide assessment of esophageal transit when a clinician evaluates impaired esophageal movement, such as in a patient with dysphagia.
Medicare pays $205.42 for 78258 nationally in the office. Local office rates run $178.92–$285.80.
Medicare rate · 78258
Esophageal motility
Swap in your local Medicare rate.
- Work RVUs
- 0.72
- Total RVUs
- 6.15
- Global days
- XXX
National rate · 2026
$205.42
Office setting, before claim adjustments.
See every locality for 78258 → · 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.
On this page 10 sections
What 78258 covers
This nuclear medicine study evaluates how material moves through the esophagus. The patient swallows a radiotracer-containing bolus while a gamma camera records its passage; the resulting images help assess esophageal transit in a patient with symptoms such as dysphagia or suspected motility impairment. Nuclear medicine staff typically perform the imaging, and a physician interprets the findings. It is distinct from pressure-based esophageal manometry.
Report the study when the record supports a radionuclide evaluation of esophageal movement, rather than a reflux or gastric-emptying assessment. Documentation should identify the clinical reason, the imaging performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Reporting without either modifier 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 78258 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$178.92 to $285.80
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $181.92 | Unavailable |
| Alaska* | $227.86 | Unavailable |
| Arizona | $199.49 | Unavailable |
| Arkansas | $178.92 | Unavailable |
| Atlanta | $208.88 | Unavailable |
| Austin | $215.52 | Unavailable |
| Bakersfield | $221.98 | Unavailable |
| Baltimore/Surr. Cntys | $219.48 | Unavailable |
| Beaumont | $189.14 | Unavailable |
| Brazoria | $203.41 | Unavailable |
| Chicago | $209.94 | Unavailable |
| Chico | $221.74 | Unavailable |
| Colorado | $216.56 | Unavailable |
| Connecticut | $220.22 | Unavailable |
| Dallas | $204.54 | Unavailable |
| Dc + Md/Va Suburbs | $238.82 | Unavailable |
| Delaware | $203.12 | Unavailable |
| Detroit | $200.99 | Unavailable |
| East St. Louis | $193.83 | Unavailable |
| El Centro | $221.75 | Unavailable |
| Fort Lauderdale | $209.90 | Unavailable |
| Fort Worth | $202.79 | Unavailable |
| Fresno | $221.74 | Unavailable |
| Galveston | $203.90 | Unavailable |
| Hanford-Corcoran | $221.74 | Unavailable |
| Hawaii, Guam | $228.77 | Unavailable |
| Houston | $205.36 | Unavailable |
| Idaho | $189.71 | Unavailable |
| Indiana | $191.00 | Unavailable |
| Iowa | $188.62 | Unavailable |
| Kansas | $186.94 | Unavailable |
| Kentucky | $185.35 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $238.20 | Unavailable |
| Madera | $221.74 | Unavailable |
| Manhattan | $237.47 | Unavailable |
| Merced | $221.74 | Unavailable |
| Metropolitan Boston | $240.77 | Unavailable |
| Metropolitan Kansas City | $194.45 | Unavailable |
| Metropolitan Philadelphia | $213.69 | Unavailable |
| Metropolitan St. Louis | $196.84 | Unavailable |
| Miami | $216.83 | Unavailable |
| Minnesota | $208.72 | Unavailable |
| Mississippi | $179.88 | Unavailable |
| Modesto | $221.74 | Unavailable |
| Montana** | $205.41 | Unavailable |
| Napa | $262.44 | Unavailable |
| Nebraska | $189.99 | Unavailable |
| Nevada** | $205.15 | Unavailable |
| New Hampshire | $212.41 | Unavailable |
| New Mexico | $191.12 | Unavailable |
| New Orleans | $195.24 | Unavailable |
| North Carolina | $192.48 | Unavailable |
| North Dakota** | $203.83 | Unavailable |
| Northern Nj | $235.70 | Unavailable |
| Nyc Suburbs/Long Island | $243.02 | Unavailable |
| Ohio | $189.89 | Unavailable |
| Oklahoma | $185.70 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $237.60 | Unavailable |
| Portland | $224.95 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $224.03 | Unavailable |
| Puerto Rico | $207.34 | Unavailable |
| Queens | $240.66 | Unavailable |
| Redding | $221.74 | Unavailable |
| Rest Of California | $221.74 | Unavailable |
| Rest Of Florida | $198.90 | Unavailable |
| Rest Of Georgia | $186.63 | Unavailable |
| Rest Of Illinois | $191.37 | Unavailable |
| Rest Of Louisiana | $184.75 | Unavailable |
| Rest Of Maine | $190.11 | Unavailable |
| Rest Of Maryland | $207.58 | Unavailable |
| Rest Of Massachusetts | $214.73 | Unavailable |
| Rest Of Michigan | $190.21 | Unavailable |
| Rest Of Missouri | $180.69 | Unavailable |
| Rest Of New Jersey | $223.08 | Unavailable |
| Rest Of New York | $195.69 | Unavailable |
| Rest Of Oregon | $203.91 | Unavailable |
| Rest Of Pennsylvania | $190.62 | Unavailable |
| Rest Of Texas | $196.04 | Unavailable |
| Rest Of Washington | $214.56 | Unavailable |
| Rhode Island | $211.48 | Unavailable |
| Riverside-San Bernardino-Ontario | $222.61 | Unavailable |
| Sacramento-Roseville-Folsom | $234.17 | Unavailable |
| Salinas | $233.33 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $239.94 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $279.52 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $279.43 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $285.80 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $285.43 | Unavailable |
| San Luis Obispo-Paso Robles | $229.42 | Unavailable |
| Santa Cruz-Watsonville | $243.10 | Unavailable |
| Santa Maria-Santa Barbara | $234.51 | Unavailable |
| Santa Rosa-Petaluma | $245.64 | Unavailable |
| Seattle (King Cnty) | $246.69 | Unavailable |
| South Carolina | $191.43 | Unavailable |
| South Dakota** | $203.64 | Unavailable |
| Southern Maine | $202.82 | Unavailable |
| Stockton | $221.74 | Unavailable |
| Suburban Chicago | $212.47 | Unavailable |
| Tennessee | $187.92 | Unavailable |
| Utah | $194.42 | Unavailable |
| Vallejo | $262.31 | Unavailable |
| Vermont | $202.31 | Unavailable |
| Virgin Islands | $207.34 | Unavailable |
| Virginia | $201.59 | Unavailable |
| Visalia | $221.74 | Unavailable |
| West Virginia | $183.16 | Unavailable |
| Wisconsin | $196.06 | Unavailable |
| Wyoming** | $204.72 | Unavailable |
| Yuba City | $221.74 | Unavailable |
78258 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.
$178.92
$253.77
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $227.86 | 1 |
| AL | $181.92 | 1 |
| AR | $178.92 | 1 |
| AZ | $199.49 | 1 |
| CA | $221.74–$285.80 | 29 |
| CO | $216.56 | 1 |
| CT | $220.22 | 1 |
| DC | $238.82 | 1 |
| DE | $203.12 | 1 |
| FL | $198.90–$216.83 | 3 |
| GA | $186.63–$208.88 | 2 |
| GU | $228.77 | 1 |
| HI | $228.77 | 1 |
| IA | $188.62 | 1 |
| ID | $189.71 | 1 |
| IL | $191.37–$212.47 | 4 |
| IN | $191.00 | 1 |
| KS | $186.94 | 1 |
| KY | $185.35 | 1 |
| LA | $184.75–$195.24 | 2 |
| MA | $214.73–$240.77 | 2 |
| MD | $207.58–$238.82 | 3 |
| ME | $190.11–$202.82 | 2 |
| MI | $190.21–$200.99 | 2 |
| MN | $208.72 | 1 |
| MO | $180.69–$196.84 | 3 |
| MS | $179.88 | 1 |
| MT | $205.41 | 1 |
| NC | $192.48 | 1 |
| ND | $203.83 | 1 |
| NE | $189.99 | 1 |
| NH | $212.41 | 1 |
| NJ | $223.08–$235.70 | 2 |
| NM | $191.12 | 1 |
| NV | $205.15 | 1 |
| NY | $195.69–$243.02 | 5 |
| OH | $189.89 | 1 |
| OK | $185.70 | 1 |
| OR | $203.91–$224.95 | 2 |
| PA | $190.62–$213.69 | 2 |
| PR | $207.34 | 1 |
| RI | $211.48 | 1 |
| SC | $191.43 | 1 |
| SD | $203.64 | 1 |
| TN | $187.92 | 1 |
| TX | $189.14–$215.52 | 8 |
| UT | $194.42 | 1 |
| VA | $201.59–$238.82 | 2 |
| VI | $207.34 | 1 |
| VT | $202.31 | 1 |
| WA | $214.56–$246.69 | 2 |
| WI | $196.06 | 1 |
| WV | $183.16 | 1 |
| WY | $204.72 | 1 |
How the 78258 rate is calculated
Each of 78258’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 · 78258
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.72Practice expense 5.35Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78258
The CMS indicators that decide how 78258 is paid alongside other services.
CMS payment indicators · 78258
Esophageal motility
| 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
78258 without 26 · national office
$205.42
Esophageal motility
78258-26 · Professional component
$33.73
Pays only the interpretation and report.
78258 compared with similar codes
Compare codes
78258 vs 78262 vs 91010 vs 78264: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78262Reflux imaging
- 78258 evaluates esophageal transit by radionuclide imaging; 78262 is focused on gastroesophageal reflux.
- 91010Esophageal manometry
- Report 91010 for catheter-based esophageal pressure and motility measurement. Report 78258 for radionuclide imaging of esophageal transit.
- 78264Gastric emptying
- 78264 evaluates gastric emptying, not movement through the esophagus. Select according to the anatomic region and functional question studied.
78258 billing questions
How is this different from esophageal manometry?
This code represents radionuclide imaging of esophageal transit. Manometry, reported with 91010, measures pressure and coordination using a catheter rather than imaging a swallowed tracer.
When should 78262 be considered instead?
Use 78262 for a radionuclide study focused on gastroesophageal reflux. Use 78258 when the clinical question is esophageal movement or transit.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff portion. Without either modifier, the claim represents the global service.
What documentation supports reporting 78258?
The record should support a radionuclide esophageal transit evaluation and include the clinical indication, imaging performed, and interpretation. Dysphagia or suspected impaired esophageal movement may support the study when documented.
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
Show the CMS file lines behind this rate
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