CPT code 78803: Tumor SPECT2026 Medicare rate & RVUs

Medicare pays $335.68 for 78803 nationally in the office. Local office rates run $292.19–$469.27.

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

What 78803 covers

This service uses a radiopharmaceutical and a gamma camera to create SPECT images that help localize tumor activity in one body area. A nuclear medicine physician interprets the study; imaging may be performed in a hospital department or outpatient imaging center. Examples of a single area include the chest, pelvis, or head and neck region.

Select this code when the study uses SPECT for one area; the number and location of imaged areas should be clear in the order and imaging report. The record should support the radiopharmaceutical study, the body area examined, the acquisition performed, and the physician’s interpretation. Report the global service without a component modifier, or separate the interpretation with modifier 26 from the equipment and staff component with modifier TC. When multiple diagnostic imaging procedures are performed, CMS multiple procedure reduction applies to both the professional and technical 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 78803 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

78803 rates by state

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

How the 78803 rate is calculated

Each of 78803’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 78803

The CMS indicators that decide how 78803 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78803 compared with similar codes

How to choose

78800Tumor imaging

Choose 78803 for SPECT localization in one area. Choose 78800 when tumor localization imaging is performed without SPECT.

78830Tumor SPECT/CT

78830 includes SPECT with a concurrently acquired CT scan for anatomic localization; 78803 reports single-area SPECT without that CT component.

78831Tumor SPECT

78803 is for SPECT localization in one area; 78831 is for studies covering two areas.

Codes related to 78803

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