Billing code 78262: Reflux imagingMedicare rate & RVUs
Reports radionuclide imaging used to assess movement of stomach contents back into the esophagus during evaluation of suspected gastroesophageal reflux.
Medicare pays $217.44 for 78262 nationally in the office. Local office rates run $188.97–$303.81.
Medicare rate · 78262
Reflux imaging
Swap in your local Medicare rate.
- Work RVUs
- 0.66
- Total RVUs
- 6.51
- Global days
- XXX
National rate · 2026
$217.44
Office setting, before claim adjustments.
See every locality for 78262 → · 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 78262 covers
A nuclear medicine technologist administers a radiolabeled liquid or meal by mouth and obtains serial gamma-camera images to look for retrograde movement from the stomach into the esophagus. A nuclear medicine physician interprets the images. The study may be performed in a hospital imaging department for patients, including infants and children, being evaluated for suspected gastroesophageal reflux.
Report 78262 when the study is directed at detecting reflux, rather than evaluating esophageal motility or gastric emptying. Documentation should identify the clinical indication, the imaging performed, and the physician’s interpretation and findings. CMS recognizes separately priced professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier when billing 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 78262 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
$188.97 to $303.81
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $192.19 | Unavailable |
| Alaska* | $239.79 | Unavailable |
| Arizona | $211.08 | Unavailable |
| Arkansas | $188.97 | Unavailable |
| Atlanta | $221.13 | Unavailable |
| Austin | $228.36 | Unavailable |
| Bakersfield | $235.32 | Unavailable |
| Baltimore/Surr. Cntys | $232.49 | Unavailable |
| Beaumont | $199.91 | Unavailable |
| Brazoria | $215.29 | Unavailable |
| Chicago | $222.02 | Unavailable |
| Chico | $235.08 | Unavailable |
| Colorado | $229.45 | Unavailable |
| Connecticut | $233.28 | Unavailable |
| Dallas | $216.49 | Unavailable |
| Dc + Md/Va Suburbs | $253.24 | Unavailable |
| Delaware | $214.97 | Unavailable |
| Detroit | $212.53 | Unavailable |
| East St. Louis | $204.73 | Unavailable |
| El Centro | $235.09 | Unavailable |
| Fort Lauderdale | $222.10 | Unavailable |
| Fort Worth | $214.60 | Unavailable |
| Fresno | $235.08 | Unavailable |
| Galveston | $215.81 | Unavailable |
| Hanford-Corcoran | $235.08 | Unavailable |
| Hawaii, Guam | $242.72 | Unavailable |
| Houston | $217.27 | Unavailable |
| Idaho | $200.61 | Unavailable |
| Indiana | $202.00 | Unavailable |
| Iowa | $199.45 | Unavailable |
| Kansas | $197.61 | Unavailable |
| Kentucky | $195.82 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $252.71 | Unavailable |
| Madera | $235.08 | Unavailable |
| Manhattan | $251.64 | Unavailable |
| Merced | $235.08 | Unavailable |
| Metropolitan Boston | $255.44 | Unavailable |
| Metropolitan Kansas City | $205.62 | Unavailable |
| Metropolitan Philadelphia | $226.25 | Unavailable |
| Metropolitan St. Louis | $208.19 | Unavailable |
| Miami | $229.43 | Unavailable |
| Minnesota | $221.15 | Unavailable |
| Mississippi | $189.95 | Unavailable |
| Modesto | $235.08 | Unavailable |
| Montana** | $217.43 | Unavailable |
| Napa | $278.80 | Unavailable |
| Nebraska | $200.94 | Unavailable |
| Nevada** | $217.19 | Unavailable |
| New Hampshire | $225.01 | Unavailable |
| New Mexico | $201.98 | Unavailable |
| New Orleans | $206.43 | Unavailable |
| North Carolina | $203.56 | Unavailable |
| North Dakota** | $215.85 | Unavailable |
| Northern Nj | $249.85 | Unavailable |
| Nyc Suburbs/Long Island | $257.57 | Unavailable |
| Ohio | $200.69 | Unavailable |
| Oklahoma | $196.22 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $252.13 | Unavailable |
| Portland | $238.50 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $237.30 | Unavailable |
| Puerto Rico | $219.52 | Unavailable |
| Queens | $255.11 | Unavailable |
| Redding | $235.08 | Unavailable |
| Rest Of California | $235.08 | Unavailable |
| Rest Of Florida | $210.30 | Unavailable |
| Rest Of Georgia | $197.14 | Unavailable |
| Rest Of Illinois | $202.18 | Unavailable |
| Rest Of Louisiana | $195.16 | Unavailable |
| Rest Of Maine | $201.01 | Unavailable |
| Rest Of Maryland | $219.75 | Unavailable |
| Rest Of Massachusetts | $227.46 | Unavailable |
| Rest Of Michigan | $201.02 | Unavailable |
| Rest Of Missouri | $190.77 | Unavailable |
| Rest Of New Jersey | $236.31 | Unavailable |
| Rest Of New York | $207.01 | Unavailable |
| Rest Of Oregon | $215.88 | Unavailable |
| Rest Of Pennsylvania | $201.49 | Unavailable |
| Rest Of Texas | $207.35 | Unavailable |
| Rest Of Washington | $227.30 | Unavailable |
| Rhode Island | $223.93 | Unavailable |
| Riverside-San Bernardino-Ontario | $235.95 | Unavailable |
| Sacramento-Roseville-Folsom | $248.41 | Unavailable |
| Salinas | $247.53 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $254.65 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $297.11 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $297.01 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $303.81 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $303.44 | Unavailable |
| San Luis Obispo-Paso Robles | $243.36 | Unavailable |
| Santa Cruz-Watsonville | $258.10 | Unavailable |
| Santa Maria-Santa Barbara | $248.81 | Unavailable |
| Santa Rosa-Petaluma | $260.80 | Unavailable |
| Seattle (King Cnty) | $261.80 | Unavailable |
| South Carolina | $202.39 | Unavailable |
| South Dakota** | $215.67 | Unavailable |
| Southern Maine | $214.72 | Unavailable |
| Stockton | $235.08 | Unavailable |
| Suburban Chicago | $224.86 | Unavailable |
| Tennessee | $198.66 | Unavailable |
| Utah | $205.60 | Unavailable |
| Vallejo | $278.67 | Unavailable |
| Vermont | $214.19 | Unavailable |
| Virgin Islands | $219.52 | Unavailable |
| Virginia | $213.38 | Unavailable |
| Visalia | $235.08 | Unavailable |
| West Virginia | $193.34 | Unavailable |
| Wisconsin | $207.50 | Unavailable |
| Wyoming** | $216.75 | Unavailable |
| Yuba City | $235.08 | Unavailable |
78262 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.
$188.97
$269.45
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 | $239.79 | 1 |
| AL | $192.19 | 1 |
| AR | $188.97 | 1 |
| AZ | $211.08 | 1 |
| CA | $235.08–$303.81 | 29 |
| CO | $229.45 | 1 |
| CT | $233.28 | 1 |
| DC | $253.24 | 1 |
| DE | $214.97 | 1 |
| FL | $210.30–$229.43 | 3 |
| GA | $197.14–$221.13 | 2 |
| GU | $242.72 | 1 |
| HI | $242.72 | 1 |
| IA | $199.45 | 1 |
| ID | $200.61 | 1 |
| IL | $202.18–$224.86 | 4 |
| IN | $202.00 | 1 |
| KS | $197.61 | 1 |
| KY | $195.82 | 1 |
| LA | $195.16–$206.43 | 2 |
| MA | $227.46–$255.44 | 2 |
| MD | $219.75–$253.24 | 3 |
| ME | $201.01–$214.72 | 2 |
| MI | $201.02–$212.53 | 2 |
| MN | $221.15 | 1 |
| MO | $190.77–$208.19 | 3 |
| MS | $189.95 | 1 |
| MT | $217.43 | 1 |
| NC | $203.56 | 1 |
| ND | $215.85 | 1 |
| NE | $200.94 | 1 |
| NH | $225.01 | 1 |
| NJ | $236.31–$249.85 | 2 |
| NM | $201.98 | 1 |
| NV | $217.19 | 1 |
| NY | $207.01–$257.57 | 5 |
| OH | $200.69 | 1 |
| OK | $196.22 | 1 |
| OR | $215.88–$238.50 | 2 |
| PA | $201.49–$226.25 | 2 |
| PR | $219.52 | 1 |
| RI | $223.93 | 1 |
| SC | $202.39 | 1 |
| SD | $215.67 | 1 |
| TN | $198.66 | 1 |
| TX | $199.91–$228.36 | 8 |
| UT | $205.60 | 1 |
| VA | $213.38–$253.24 | 2 |
| VI | $219.52 | 1 |
| VT | $214.19 | 1 |
| WA | $227.30–$261.80 | 2 |
| WI | $207.50 | 1 |
| WV | $193.34 | 1 |
| WY | $216.75 | 1 |
How the 78262 rate is calculated
Each of 78262’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 · 78262
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.66Practice expense 5.77Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78262
The CMS indicators that decide how 78262 is paid alongside other services.
CMS payment indicators · 78262
Reflux imaging
| 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
78262 without 26 · national office
$217.44
Reflux imaging
78262-26 · Professional component
$31.40
Pays only the interpretation and report.
78262 compared with similar codes
Compare codes
78262 vs 78258 vs 78264 vs 74220: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78258Esophageal motility
- 78262 assesses reflux from the stomach into the esophagus; 78258 evaluates esophageal motility.
- 78264Gastric emptying
- 78262 looks for reflux, while 78264 evaluates how quickly the stomach empties.
- 74220Esophagram
- 78262 uses radionuclide imaging to assess reflux; 74220 is a radiographic examination of the esophagus.
78262 billing questions
When should 78262 be selected instead of 78258?
Use 78262 for radionuclide assessment of reflux from the stomach into the esophagus. Code 78258 evaluates esophageal motility.
How are the professional and technical services reported?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
What documentation supports 78262?
Document the suspected reflux indication, the radionuclide imaging performed, and the interpreting physician’s findings and conclusion.
Is 78262 the code for a gastric emptying study?
No. Code 78262 assesses reflux into the esophagus; 78264 is used for gastric emptying imaging.
How does 78262 differ from an esophagram?
Code 78262 reports radionuclide imaging for reflux. An esophagram such as 74220 uses radiographic imaging to examine the esophagus.
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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