Billing code 78278: GI bleeding scanMedicare rate & RVUs
Nuclear medicine imaging tracks suspected active gastrointestinal bleeding to help localize blood loss, including bleeding that may occur intermittently.
Medicare pays $305.62 for 78278 nationally in the office. Local office rates run $265.95–$426.92.
Medicare rate · 78278
GI bleeding scan
- Work RVUs
- 0.97
- Total RVUs
- 9.15
- Global days
- XXX
National rate · 2026
$305.62
Office setting, before claim adjustments.
See every locality for 78278 →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 78278 covers
This study uses nuclear medicine imaging to look for and localize active blood loss into the gastrointestinal tract. A common approach uses the patient’s radiolabeled red blood cells, with serial imaging to follow suspected bleeding over time. It is typically performed in a nuclear medicine department for patients with suspected acute gastrointestinal hemorrhage, including cases in which bleeding is intermittent and localization is needed to guide care. A nuclear medicine physician or radiologist interprets the images; technologists perform the imaging and related technical work.
Report 78278 for imaging directed at acute GI blood loss, rather than a study aimed at another question such as gastric emptying or intestinal protein loss. The record should support the bleeding indication and include the study and interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Serial images within the study do not represent separate services.
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 78278 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
$265.95 to $426.92
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $270.43 | Unavailable |
| Alaska* | $337.86 | Unavailable |
| Arizona | $296.77 | Unavailable |
| Arkansas | $265.95 | Unavailable |
| Atlanta | $310.70 | Unavailable |
| Austin | $320.96 | Unavailable |
| Bakersfield | $330.84 | Unavailable |
| Baltimore/Surr. Cntys | $326.63 | Unavailable |
| Beaumont | $281.09 | Unavailable |
| Brazoria | $302.71 | Unavailable |
| Chicago | $311.52 | Unavailable |
| Chico | $330.53 | Unavailable |
| Colorado | $322.55 | Unavailable |
| Connecticut | $327.75 | Unavailable |
| Dallas | $304.36 | Unavailable |
| Dc + Md/Va Suburbs | $355.78 | Unavailable |
| Delaware | $302.20 | Unavailable |
| Detroit | $298.46 | Unavailable |
| East St. Louis | $287.41 | Unavailable |
| El Centro | $330.54 | Unavailable |
| Fort Lauderdale | $311.83 | Unavailable |
| Fort Worth | $301.70 | Unavailable |
| Fresno | $330.53 | Unavailable |
| Galveston | $303.41 | Unavailable |
| Hanford-Corcoran | $330.53 | Unavailable |
| Hawaii, Guam | $341.19 | Unavailable |
| Houston | $305.24 | Unavailable |
| Idaho | $282.27 | Unavailable |
| Indiana | $284.20 | Unavailable |
| Iowa | $280.66 | Unavailable |
| Kansas | $278.05 | Unavailable |
| Kentucky | $275.38 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $355.21 | Unavailable |
| Madera | $330.53 | Unavailable |
| Manhattan | $353.37 | Unavailable |
| Merced | $330.53 | Unavailable |
| Metropolitan Boston | $358.94 | Unavailable |
| Metropolitan Kansas City | $289.08 | Unavailable |
| Metropolitan Philadelphia | $317.91 | Unavailable |
| Metropolitan St. Louis | $292.67 | Unavailable |
| Miami | $321.79 | Unavailable |
| Minnesota | $311.09 | Unavailable |
| Mississippi | $267.23 | Unavailable |
| Modesto | $330.53 | Unavailable |
| Montana** | $305.61 | Unavailable |
| Napa | $391.84 | Unavailable |
| Nebraska | $282.76 | Unavailable |
| Nevada** | $305.33 | Unavailable |
| New Hampshire | $316.27 | Unavailable |
| New Mexico | $283.89 | Unavailable |
| New Orleans | $290.15 | Unavailable |
| North Carolina | $286.33 | Unavailable |
| North Dakota** | $303.63 | Unavailable |
| Northern Nj | $351.07 | Unavailable |
| Nyc Suburbs/Long Island | $361.56 | Unavailable |
| Ohio | $282.17 | Unavailable |
| Oklahoma | $276.00 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $354.38 | Unavailable |
| Portland | $335.24 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $333.42 | Unavailable |
| Puerto Rico | $308.54 | Unavailable |
| Queens | $358.29 | Unavailable |
| Redding | $330.53 | Unavailable |
| Rest Of California | $330.53 | Unavailable |
| Rest Of Florida | $295.42 | Unavailable |
| Rest Of Georgia | $277.11 | Unavailable |
| Rest Of Illinois | $284.02 | Unavailable |
| Rest Of Louisiana | $274.44 | Unavailable |
| Rest Of Maine | $282.77 | Unavailable |
| Rest Of Maryland | $308.91 | Unavailable |
| Rest Of Massachusetts | $319.76 | Unavailable |
| Rest Of Michigan | $282.57 | Unavailable |
| Rest Of Missouri | $268.29 | Unavailable |
| Rest Of New Jersey | $332.07 | Unavailable |
| Rest Of New York | $291.13 | Unavailable |
| Rest Of Oregon | $303.55 | Unavailable |
| Rest Of Pennsylvania | $283.30 | Unavailable |
| Rest Of Texas | $291.53 | Unavailable |
| Rest Of Washington | $319.54 | Unavailable |
| Rhode Island | $314.78 | Unavailable |
| Riverside-San Bernardino-Ontario | $331.62 | Unavailable |
| Sacramento-Roseville-Folsom | $349.23 | Unavailable |
| Salinas | $347.98 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $357.96 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $417.54 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $417.43 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $426.92 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $426.45 | Unavailable |
| San Luis Obispo-Paso Robles | $342.13 | Unavailable |
| Santa Cruz-Watsonville | $362.77 | Unavailable |
| Santa Maria-Santa Barbara | $349.78 | Unavailable |
| Santa Rosa-Petaluma | $366.57 | Unavailable |
| Seattle (King Cnty) | $367.89 | Unavailable |
| South Carolina | $284.61 | Unavailable |
| South Dakota** | $303.40 | Unavailable |
| Southern Maine | $301.96 | Unavailable |
| Stockton | $330.53 | Unavailable |
| Suburban Chicago | $315.71 | Unavailable |
| Tennessee | $279.51 | Unavailable |
| Utah | $289.08 | Unavailable |
| Vallejo | $391.67 | Unavailable |
| Vermont | $301.27 | Unavailable |
| Virgin Islands | $308.54 | Unavailable |
| Virginia | $300.05 | Unavailable |
| Visalia | $330.53 | Unavailable |
| West Virginia | $271.70 | Unavailable |
| Wisconsin | $291.97 | Unavailable |
| Wyoming** | $304.75 | Unavailable |
| Yuba City | $330.53 | Unavailable |
78278 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.
$265.95
$378.73
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 | $337.86 | 1 |
| AL | $270.43 | 1 |
| AR | $265.95 | 1 |
| AZ | $296.77 | 1 |
| CA | $330.53–$426.92 | 29 |
| CO | $322.55 | 1 |
| CT | $327.75 | 1 |
| DC | $355.78 | 1 |
| DE | $302.20 | 1 |
| FL | $295.42–$321.79 | 3 |
| GA | $277.11–$310.70 | 2 |
| GU | $341.19 | 1 |
| HI | $341.19 | 1 |
| IA | $280.66 | 1 |
| ID | $282.27 | 1 |
| IL | $284.02–$315.71 | 4 |
| IN | $284.20 | 1 |
| KS | $278.05 | 1 |
| KY | $275.38 | 1 |
| LA | $274.44–$290.15 | 2 |
| MA | $319.76–$358.94 | 2 |
| MD | $308.91–$355.78 | 3 |
| ME | $282.77–$301.96 | 2 |
| MI | $282.57–$298.46 | 2 |
| MN | $311.09 | 1 |
| MO | $268.29–$292.67 | 3 |
| MS | $267.23 | 1 |
| MT | $305.61 | 1 |
| NC | $286.33 | 1 |
| ND | $303.63 | 1 |
| NE | $282.76 | 1 |
| NH | $316.27 | 1 |
| NJ | $332.07–$351.07 | 2 |
| NM | $283.89 | 1 |
| NV | $305.33 | 1 |
| NY | $291.13–$361.56 | 5 |
| OH | $282.17 | 1 |
| OK | $276.00 | 1 |
| OR | $303.55–$335.24 | 2 |
| PA | $283.30–$317.91 | 2 |
| PR | $308.54 | 1 |
| RI | $314.78 | 1 |
| SC | $284.61 | 1 |
| SD | $303.40 | 1 |
| TN | $279.51 | 1 |
| TX | $281.09–$320.96 | 8 |
| UT | $289.08 | 1 |
| VA | $300.05–$355.78 | 2 |
| VI | $308.54 | 1 |
| VT | $301.27 | 1 |
| WA | $319.54–$367.89 | 2 |
| WI | $291.97 | 1 |
| WV | $271.70 | 1 |
| WY | $304.75 | 1 |
How the 78278 rate is calculated
Each of 78278’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 · 78278
RVUs × geographic indexes × conversion factor
Work0.97
0.97 RVUs× 1.000 GPCI
Practice expense8.08
8.08 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
9.1500
Conversion factor
$33.4009
Medicare rate
$305.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78278
The CMS indicators that decide how 78278 is paid alongside other services.
CMS payment indicators · 78278
GI bleeding scan
| 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
78278 without 26 · national office
$305.62
GI bleeding scan
78278-26 · Professional component
$45.09
Pays only the interpretation and report.
78278 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78290Intestinal imaging
- 78278 targets suspected GI blood loss; 78290 describes intestine imaging for a different diagnostic purpose.
- 78282Gi protein loss
- 78282 evaluates gastrointestinal protein loss, not active bleeding.
- 78299Unlisted gi px dx nuc med
- Use 78278 when the performed study is the defined GI blood loss imaging service; 78299 is for an unlisted GI nuclear medicine procedure.
78278 billing questions
When should 78278 be selected instead of intestine imaging?
Use 78278 when the imaging is directed at locating suspected gastrointestinal blood loss. Intestinal imaging such as 78290 addresses a different diagnostic question.
Can the interpretation and imaging be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
Are serial images separate units?
No. Serial images used to follow possible bleeding are part of the imaging study, not separate services.
What documentation supports reporting 78278?
Document the suspected acute GI bleeding indication and the imaging performed to detect or localize blood loss. The interpretation should describe the findings relevant to that question.
Is a radiopharmaceutical code commonly reported with this study?
The radiolabeled red blood cell supply may be reported separately when applicable; A9560 identifies technetium Tc-99m labeled red blood cells.
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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