Billing code 78740: Reflux studyMedicare rate & RVUs

Medicare pays $220.78 for 78740 nationally in the office. Local office rates run $191.60–$310.34.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 78740 covers

This nuclear medicine study evaluates whether urine flows backward from the bladder into the ureters, and sometimes toward the kidneys. A radiopharmaceutical is introduced into the bladder and images are obtained during filling and voiding. It is commonly used when vesicoureteral reflux is suspected, including in the evaluation of recurrent urinary tract infections, and may be performed in a nuclear medicine or radiology department. A nuclear medicine physician or radiologist interprets the images.

Select this code when the documented examination is a radionuclide ureteral reflux study, rather than imaging focused on renal drainage or bladder emptying. The record should support the reflux question and the imaging performed. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment-and-staff service; an unmodified claim represents the global service, including both components. CMS separately prices the 26 and TC components.

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 78740 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

78740 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 78740 rate is calculated

Each of 78740’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.

Payment rules and modifiers for 78740

The CMS indicators that decide how 78740 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78740 compared with similar codes

How to choose

74455Voiding study

Use 78740 for the radionuclide reflux examination; 74455 is the fluoroscopic voiding cystourethrography service.

78708Renal imaging

78708 evaluates renal flow and function with a pharmacologic intervention; 78740 evaluates reflux from the bladder into the ureters.

78730Bladder ultrasound

78730 is a urinary bladder retention study. Choose 78740 when the diagnostic question is ureteral reflux, not retained bladder volume.

Codes related to 78740

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates