Billing code 78801: Tumor imagingMedicare rate & RVUs

Reports one-day radiopharmaceutical tumor-localization imaging covering two or more areas, such as when a nuclear medicine study evaluates multiple suspected tumor sites.

CMS RVU26DEffective Oct 1, 2026109 payment localities838 Medicare services in 2024

Medicare pays $240.15 for 78801 nationally in the office. Local office rates run $208.72–$336.01.

Medicare rate · 78801

Tumor imaging

Swap in your local Medicare rate.

Work RVUs
0.71
Total RVUs
7.19
Global days
XXX

National rate · 2026

$240.15

Office setting, before claim adjustments.

See every locality for 78801 → · 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 78801 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 78801 covers

This nuclear medicine study uses a radioactive tracer to produce images that help locate tumor tissue in two or more areas during one day of imaging. A nuclear medicine technologist typically performs the acquisition in a hospital or imaging center, and a radiologist or nuclear medicine physician interprets the study. The selected code reflects the extent and timing of the imaging, not the number of lesions found.

Document the clinical indication, radiopharmaceutical used, areas imaged, imaging date, and interpretation. Report one service for the two-or-more-area, one-day study; the code is not selected per lesion. It is a diagnostic test with separately identifiable professional and technical components: modifier 26 reports interpretation, modifier TC reports equipment and staff, and no component modifier represents the global service. Radiopharmaceutical injection may be separately represented by 78808 when applicable.

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 78801 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

$208.72 to $336.01

$208.72$272.37$336.01
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

78801 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$212.27Unavailable
Alaska*$264.70Unavailable
Arizona$233.14Unavailable
Arkansas$208.72Unavailable
Atlanta$244.18Unavailable
Austin$252.29Unavailable
Bakersfield$260.08Unavailable
Baltimore/Surr. Cntys$256.77Unavailable
Beaumont$220.72Unavailable
Brazoria$237.83Unavailable

78801 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.

$208.72

$297.92

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

View every state and territory as a table
78801 office rate range by state
State / territoryOffice rate rangeLocalities
AK$264.701
AL$212.271
AR$208.721
AZ$233.141
CA$259.84–$336.0129
CO$253.531
CT$257.651
DC$279.791
DE$237.441
FL$232.09–$253.003
GA$217.58–$244.182
GU$268.311
HI$268.311
IA$220.371
ID$221.641
IL$223.06–$248.154
IN$223.171
KS$218.311
KY$216.201
LA$215.46–$227.902
MA$251.32–$282.302
MD$242.74–$279.793
ME$222.04–$237.242
MI$221.90–$234.502
MN$244.471
MO$210.58–$229.903
MS$209.741
MT$240.151
NC$224.871
ND$238.571
NE$222.031
NH$248.581
NJ$261.03–$276.032
NM$222.951
NV$239.921
NY$228.67–$284.365
OH$221.581
OK$216.681
OR$238.50–$263.582
PA$222.48–$249.862
PR$242.461
RI$247.371
SC$223.511
SD$238.381
TN$219.461
TX$220.72–$252.298
UT$227.051
VA$235.73–$279.792
VI$242.461
VT$236.691
WA$251.15–$289.372
WI$229.331
WV$213.301
WY$239.461

How the 78801 rate is calculated

Each of 78801’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 · 78801

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.71Practice expense 6.40Malpractice 0.08

7.1900 adjusted RVUs×$33.4009 conversion factor=$240.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 78801

The CMS indicators that decide how 78801 is paid alongside other services.

CMS payment indicators · 78801

Tumor 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

78801 without 26 · national office

$240.15

Tumor imaging

78801-26 · Professional component

$33.07

Pays only the interpretation and report.

When to use modifier 26

78801 compared with similar codes

Compare codes

78801 vs 78800 vs 78802 vs 78804 vs 78831: national Medicare rates

Swap in your local Medicare rate.

  • 78801
    Tumor imaging · 0.71 wRVU
    $240.15
  • 78800
    Tumor imaging · 0.62 wRVU
    $231.80−$8.35
  • 78802
    Tumor imaging · 0.78 wRVU
    $270.21+$30.06
  • 78804
    Tumor localization · 0.98 wRVU
    $561.14+$320.99
  • 78831
    Tumor SPECT · 1.77 wRVU
    $622.93+$382.78

How to choose

78800Tumor imaging
Use 78800 for one imaged area during one day; use 78801 when two or more areas are imaged that day.
78802Tumor imaging
78802 describes whole-body tumor localization with one-day imaging. 78801 describes two or more areas rather than a whole-body study.
78804Tumor localization
78804 is for whole-body imaging performed over two or more days; 78801 is for two or more areas imaged in one day.
78831Tumor SPECT
78831 is the SPECT study for two or more areas. Choose 78801 when the study is not reported as SPECT.

78801 billing questions

When should 78801 be selected instead of 78800?

Use 78801 when tumor-localization imaging covers two or more areas in one day. Code 78800 describes one area with one-day imaging.

Does this code include radiopharmaceutical administration?

The imaging code describes the localization study. Code 78808 represents injection for a diagnostic radiopharmaceutical study and may be reported with it when applicable.

How are the professional and technical services billed?

Use modifier 26 for the interpretation and report, or modifier TC for the equipment and staff. Report the service without either modifier when billing globally.

What documentation supports reporting two or more areas?

The record should identify the areas imaged, the study date, the radiopharmaceutical, the indication, and the interpreting physician’s findings. It should support imaging of at least two areas during the one-day study.

How does 78801 differ from whole-body imaging?

78801 is for two or more areas imaged in one day. Whole-body studies use the whole-body codes, with 78804 identifying imaging over two or more days.

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 78801PPRRVU2026_Oct_nonQPP.csv, line 9,515 (RVU26D)

Open CMS sourceHow we calculate rates

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