Billing code 78290: Intestinal imagingMedicare rate & RVUs

Reports intestinal scintigraphy, commonly used to locate ectopic gastric mucosa such as in suspected Meckel diverticulum, with professional and technical components available.

CMS RVU26DEffective Oct 1, 2026109 payment localities233 Medicare services in 2024

Medicare pays $290.92 for 78290 nationally in the office. Local office rates run $251.98–$409.47.

Medicare rate · 78290

Intestinal imaging

Work RVUs
0.66
Total RVUs
8.71
Global days
XXX

National rate · 2026

$290.92

Office setting, before claim adjustments.

See every locality for 78290 →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
  1. Medicare rate
  2. What 78290 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78290 covers

This nuclear medicine examination images the intestine, commonly to detect ectopic gastric mucosa in a patient being evaluated for a Meckel diverticulum. A nuclear medicine technologist performs the imaging, and a nuclear medicine physician interprets the study. It is typically performed in a hospital or outpatient nuclear medicine department; a common clinical presentation is a child with painless gastrointestinal bleeding and suspected Meckel diverticulum.

Select this code when the study is directed at intestinal localization, rather than gastric emptying, bowel transit, or active bleeding localization. Documentation should identify the clinical indication, imaging performed, and interpretation supporting the intestinal focus. CMS allows the service to be billed globally without a component modifier, or split between the professional interpretation with modifier 26 and the technical service with modifier TC. The technical component represents the equipment and staff; the professional component represents interpretation.

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 78290 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

$251.98 to $409.47

$251.98$330.73$409.47
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

78290 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$256.38Unavailable
Alaska*$317.88Unavailable
Arizona$282.25Unavailable
Arkansas$251.98Unavailable
Atlanta$295.85Unavailable
Austin$306.04Unavailable
Bakersfield$315.69Unavailable
Baltimore/Surr. Cntys$311.40Unavailable
Beaumont$266.78Unavailable
Brazoria$288.04Unavailable

78290 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.

$251.98

$362.45

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78290 office rate range by state
State / territoryOffice rate rangeLocalities
AK$317.881
AL$256.381
AR$251.981
AZ$282.251
CA$315.43–$409.4729
CO$307.541
CT$312.471
DC$339.781
DE$287.541
FL$280.74–$306.423
GA$262.78–$295.852
GU$326.081
HI$326.081
IA$266.511
ID$268.071
IL$269.48–$300.584
IN$269.971
KS$263.911
KY$261.151
LA$260.22–$275.642
MA$304.76–$343.072
MD$294.09–$339.783
ME$268.52–$287.422
MI$268.18–$283.682
MN$296.521
MO$254.15–$278.173
MS$253.181
MT$290.921
NC$272.021
ND$289.141
NE$268.581
NH$301.451
NJ$316.56–$335.052
NM$269.461
NV$290.691
NY$276.74–$345.165
OH$267.821
OK$261.801
OR$288.97–$320.022
PA$268.96–$302.802
PR$293.801
RI$299.791
SC$270.261
SD$288.931
TN$265.341
TX$266.78–$306.048
UT$274.661
VA$285.52–$339.782
VI$293.801
VT$286.781
WA$304.58–$351.832
WI$277.681
WV$257.391
WY$290.141

How the 78290 rate is calculated

Each of 78290’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 · 78290

RVUs × geographic indexes × conversion factor

Work0.66

0.66 RVUs× 1.000 GPCI

Practice expense7.96

7.96 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

8.7100

Conversion factor

$33.4009

Medicare rate

$290.92

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 78290

The CMS indicators that decide how 78290 is paid alongside other services.

CMS payment indicators · 78290

Intestinal imaging

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78290 without 26 · national office

$290.92

Intestinal imaging

78290-26 · Professional component

$31.06

Pays only the interpretation and report.

When to use modifier 26

78290 compared with similar codes

Compare codes · National

4 codes, side by side

  • 78290

    Intestinal imaging0.66 wRVU

    $290.92

  • 78261

    Gastric mucosa scan0.67 wRVU

    $183.70−$107.22

  • 78278

    GI bleeding scan0.97 wRVU

    $305.62+$14.70

  • 78265

    Gastric emptying0.96 wRVU

    $347.70+$56.78

How to choose

78261Gastric mucosa scan
Choose 78290 for an intestine-directed study, commonly to locate ectopic gastric mucosa. Choose 78261 when the imaging target is the gastric mucosa.
78278GI bleeding scan
78278 is for imaging to localize acute gastrointestinal blood loss; 78290 is used for intestinal imaging such as evaluation for ectopic gastric mucosa.
78265Gastric emptying
78265 evaluates gastric emptying and includes small-bowel transit imaging. It is not the code for an intestinal study directed at ectopic gastric mucosa.

78290 billing questions

When is this code appropriate for a suspected Meckel diverticulum?

Use it when the nuclear medicine study is directed at locating ectopic gastric mucosa in the intestine, a common reason to evaluate for Meckel diverticulum.

How does this differ from gastric mucosa imaging?

This code represents intestine-directed imaging, often for ectopic gastric mucosa. Use gastric mucosa imaging when the study is directed at the stomach itself.

Can the professional and technical services be billed separately?

Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical service; without either modifier, the claim represents the global service.

What documentation supports reporting this code?

The record should establish the intestinal imaging indication, such as suspected ectopic gastric mucosa, and include the imaging performed and the interpreting physician's findings.

Is this the code for locating active gastrointestinal bleeding?

Use the acute gastrointestinal blood-loss imaging code when the study is directed at localizing active bleeding. This code is for intestinal imaging such as evaluation for ectopic gastric mucosa.

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
RVUs for 78290PPRRVU2026_Oct_nonQPP.csv, line 9,310 (RVU26D)

Open CMS sourceHow we calculate rates

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