Billing code 78265: Gastric emptyingMedicare rate & RVUs
Reports gastric emptying imaging that also tracks transit through the small bowel, providing assessment of gastric and small bowel movement.
Medicare pays $347.70 for 78265 nationally in the office. Local office rates run $301.93–$487.41.
Medicare rate · 78265
Gastric emptying
- Work RVUs
- 0.96
- Total RVUs
- 10.41
- Global days
- XXX
National rate · 2026
$347.70
Office setting, before claim adjustments.
See every locality for 78265 →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 78265 covers
This nuclear medicine study follows a radiolabeled meal as it leaves the stomach and moves through the small bowel. A nuclear medicine technologist typically prepares or administers the tracer meal and obtains serial images; a nuclear medicine physician interprets the study. It is used when the clinical question includes both gastric emptying and small bowel transit, such as evaluation of delayed gastric emptying with downstream transit assessment.
Select this code when the imaging study includes small bowel transit, rather than gastric emptying alone or transit through both the small bowel and colon. The report should identify the study performed and document the imaging and interpretation. CMS recognizes separately billable professional and technical components: use modifier 26 for the interpretation, modifier TC for equipment and staff, or bill without a modifier for 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 78265 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
$301.93 to $487.41
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $307.11 | Unavailable |
| Alaska* | $382.36 | Unavailable |
| Arizona | $337.50 | Unavailable |
| Arkansas | $301.93 | Unavailable |
| Atlanta | $353.53 | Unavailable |
| Austin | $365.44 | Unavailable |
| Bakersfield | $376.82 | Unavailable |
| Baltimore/Surr. Cntys | $371.86 | Unavailable |
| Beaumont | $319.37 | Unavailable |
| Brazoria | $344.34 | Unavailable |
| Chicago | $354.25 | Unavailable |
| Chico | $376.49 | Unavailable |
| Colorado | $367.25 | Unavailable |
| Connecticut | $373.14 | Unavailable |
| Dallas | $346.22 | Unavailable |
| Dc + Md/Va Suburbs | $405.38 | Unavailable |
| Delaware | $343.75 | Unavailable |
| Detroit | $339.31 | Unavailable |
| East St. Louis | $326.47 | Unavailable |
| El Centro | $376.51 | Unavailable |
| Fort Lauderdale | $354.73 | Unavailable |
| Fort Worth | $343.15 | Unavailable |
| Fresno | $376.49 | Unavailable |
| Galveston | $345.14 | Unavailable |
| Hanford-Corcoran | $376.49 | Unavailable |
| Hawaii, Guam | $388.90 | Unavailable |
| Houston | $347.16 | Unavailable |
| Idaho | $320.81 | Unavailable |
| Indiana | $323.04 | Unavailable |
| Iowa | $318.97 | Unavailable |
| Kansas | $315.93 | Unavailable |
| Kentucky | $312.76 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $404.87 | Unavailable |
| Madera | $376.49 | Unavailable |
| Manhattan | $402.45 | Unavailable |
| Merced | $376.49 | Unavailable |
| Metropolitan Boston | $409.13 | Unavailable |
| Metropolitan Kansas City | $328.59 | Unavailable |
| Metropolitan Philadelphia | $361.78 | Unavailable |
| Metropolitan St. Louis | $332.74 | Unavailable |
| Miami | $366.11 | Unavailable |
| Minnesota | $354.16 | Unavailable |
| Mississippi | $303.38 | Unavailable |
| Modesto | $376.49 | Unavailable |
| Montana** | $347.70 | Unavailable |
| Napa | $447.12 | Unavailable |
| Nebraska | $321.40 | Unavailable |
| Nevada** | $347.40 | Unavailable |
| New Hampshire | $360.03 | Unavailable |
| New Mexico | $322.55 | Unavailable |
| New Orleans | $329.80 | Unavailable |
| North Carolina | $325.48 | Unavailable |
| North Dakota** | $345.52 | Unavailable |
| Northern Nj | $399.89 | Unavailable |
| Nyc Suburbs/Long Island | $411.87 | Unavailable |
| Ohio | $320.59 | Unavailable |
| Oklahoma | $313.50 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $403.99 | Unavailable |
| Portland | $381.90 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $379.55 | Unavailable |
| Puerto Rico | $351.08 | Unavailable |
| Queens | $408.16 | Unavailable |
| Redding | $376.49 | Unavailable |
| Rest Of California | $376.49 | Unavailable |
| Rest Of Florida | $335.83 | Unavailable |
| Rest Of Georgia | $314.72 | Unavailable |
| Rest Of Illinois | $322.63 | Unavailable |
| Rest Of Louisiana | $311.67 | Unavailable |
| Rest Of Maine | $321.36 | Unavailable |
| Rest Of Maryland | $351.47 | Unavailable |
| Rest Of Massachusetts | $364.00 | Unavailable |
| Rest Of Michigan | $321.04 | Unavailable |
| Rest Of Missouri | $304.56 | Unavailable |
| Rest Of New Jersey | $378.04 | Unavailable |
| Rest Of New York | $331.01 | Unavailable |
| Rest Of Oregon | $345.36 | Unavailable |
| Rest Of Pennsylvania | $321.92 | Unavailable |
| Rest Of Texas | $331.44 | Unavailable |
| Rest Of Washington | $363.78 | Unavailable |
| Rhode Island | $358.21 | Unavailable |
| Riverside-San Bernardino-Ontario | $377.69 | Unavailable |
| Sacramento-Roseville-Folsom | $398.00 | Unavailable |
| Salinas | $396.59 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $408.13 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $476.67 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $476.54 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $487.41 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $486.90 | Unavailable |
| San Luis Obispo-Paso Robles | $389.91 | Unavailable |
| Santa Cruz-Watsonville | $413.74 | Unavailable |
| Santa Maria-Santa Barbara | $398.68 | Unavailable |
| Santa Rosa-Petaluma | $418.09 | Unavailable |
| Seattle (King Cnty) | $419.45 | Unavailable |
| South Carolina | $323.44 | Unavailable |
| South Dakota** | $345.26 | Unavailable |
| Southern Maine | $343.54 | Unavailable |
| Stockton | $376.49 | Unavailable |
| Suburban Chicago | $359.19 | Unavailable |
| Tennessee | $317.61 | Unavailable |
| Utah | $328.61 | Unavailable |
| Vallejo | $446.94 | Unavailable |
| Vermont | $342.77 | Unavailable |
| Virgin Islands | $351.08 | Unavailable |
| Virginia | $341.32 | Unavailable |
| Visalia | $376.49 | Unavailable |
| West Virginia | $308.42 | Unavailable |
| Wisconsin | $332.06 | Unavailable |
| Wyoming** | $346.75 | Unavailable |
| Yuba City | $376.49 | Unavailable |
78265 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.
$301.93
$431.95
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 | $382.36 | 1 |
| AL | $307.11 | 1 |
| AR | $301.93 | 1 |
| AZ | $337.50 | 1 |
| CA | $376.49–$487.41 | 29 |
| CO | $367.25 | 1 |
| CT | $373.14 | 1 |
| DC | $405.38 | 1 |
| DE | $343.75 | 1 |
| FL | $335.83–$366.11 | 3 |
| GA | $314.72–$353.53 | 2 |
| GU | $388.90 | 1 |
| HI | $388.90 | 1 |
| IA | $318.97 | 1 |
| ID | $320.81 | 1 |
| IL | $322.63–$359.19 | 4 |
| IN | $323.04 | 1 |
| KS | $315.93 | 1 |
| KY | $312.76 | 1 |
| LA | $311.67–$329.80 | 2 |
| MA | $364.00–$409.13 | 2 |
| MD | $351.47–$405.38 | 3 |
| ME | $321.36–$343.54 | 2 |
| MI | $321.04–$339.31 | 2 |
| MN | $354.16 | 1 |
| MO | $304.56–$332.74 | 3 |
| MS | $303.38 | 1 |
| MT | $347.70 | 1 |
| NC | $325.48 | 1 |
| ND | $345.52 | 1 |
| NE | $321.40 | 1 |
| NH | $360.03 | 1 |
| NJ | $378.04–$399.89 | 2 |
| NM | $322.55 | 1 |
| NV | $347.40 | 1 |
| NY | $331.01–$411.87 | 5 |
| OH | $320.59 | 1 |
| OK | $313.50 | 1 |
| OR | $345.36–$381.90 | 2 |
| PA | $321.92–$361.78 | 2 |
| PR | $351.08 | 1 |
| RI | $358.21 | 1 |
| SC | $323.44 | 1 |
| SD | $345.26 | 1 |
| TN | $317.61 | 1 |
| TX | $319.37–$365.44 | 8 |
| UT | $328.61 | 1 |
| VA | $341.32–$405.38 | 2 |
| VI | $351.08 | 1 |
| VT | $342.77 | 1 |
| WA | $363.78–$419.45 | 2 |
| WI | $332.06 | 1 |
| WV | $308.42 | 1 |
| WY | $346.75 | 1 |
How the 78265 rate is calculated
Each of 78265’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 · 78265
RVUs × geographic indexes × conversion factor
Work0.96
0.96 RVUs× 1.000 GPCI
Practice expense9.34
9.34 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
10.4100
Conversion factor
$33.4009
Medicare rate
$347.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78265
The CMS indicators that decide how 78265 is paid alongside other services.
CMS payment indicators · 78265
Gastric emptying
| 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
78265 without 26 · national office
$347.70
Gastric emptying
78265-26 · Professional component
$44.76
Pays only the interpretation and report.
78265 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78264Gastric emptying
- 78264 covers gastric emptying imaging alone. Choose 78265 when the study also assesses transit through the small bowel.
- 78266GI transit imaging
- 78266 includes transit through both the small bowel and colon. Choose 78265 when the documented study includes small bowel transit but not colon transit.
- 78262Reflux imaging
- 78262 is a gastroesophageal reflux study, not imaging that tracks gastric emptying and small bowel transit.
78265 billing questions
How does this differ from 78264?
Use 78265 when the study includes small bowel transit as well as gastric emptying. Code 78264 describes gastric emptying imaging without that transit component.
When is 78266 a better fit?
Use 78266 when the study follows transit through the small bowel and colon. This code covers gastric emptying with small bowel transit, without the colon-transit scope.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting this code?
Document that gastric emptying imaging included assessment of small bowel transit, along with the study performed and the interpretation. The documented scope helps distinguish it from gastric-only imaging and studies that also include colon transit.
Should 78264 also be reported for the gastric portion?
When the single study includes both gastric emptying and small bowel transit, report the code matching that combined scope rather than separately reporting 78264 for its gastric portion.
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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