Billing code 78835: Radiopharmaceutical quantificationMedicare rate & RVUs

This add-on measurement quantifies radiopharmaceutical activity in one organ, lesion, or region during a related nuclear medicine localization study.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.7K Medicare services in 2024

Medicare pays $89.85 for 78835 nationally in the office. Local office rates run $79.00–$123.55.

Medicare rate · 78835

Radiopharmaceutical quantification

Swap in your local Medicare rate.

Work RVUs
0.46
Total RVUs
2.69
Global days
ZZZ

National rate · 2026

$89.85

Office setting, before claim adjustments.

See every locality for 78835 → · 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 78835 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 78835 covers

Code 78835 captures quantitative measurement of radiopharmaceutical activity in one defined area, such as an organ, lesion, or region. It is reported with an eligible radiopharmaceutical localization study when the interpreting nuclear medicine physician quantifies activity beyond describing its location or appearance. The service may involve image processing and measurement from the study’s acquired data; the imaging team typically includes a nuclear medicine technologist and a physician who interprets the results.

Report one unit for each separately quantified area, and pair the add-on with the applicable primary localization procedure. The record should identify the area measured and include the quantitative findings and interpretation. This code is not reported by itself; CMS pays it within the primary procedure’s global period. The diagnostic service has professional and technical components: modifier 26 identifies the physician’s interpretation, modifier TC identifies the equipment and staff, and no component modifier represents the global service.

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 78835 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

$79.00 to $123.55

$79.00$101.28$123.55
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

78835 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$80.23Unavailable
Alaska*$101.86Unavailable
Arizona$87.43Unavailable
Arkansas$79.00Unavailable
Atlanta$91.27Unavailable
Austin$94.03Unavailable
Bakersfield$96.80Unavailable
Baltimore/Surr. Cntys$95.70Unavailable
Beaumont$83.16Unavailable
Brazoria$89.09Unavailable

78835 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.

$79.00

$110.13

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

View every state and territory as a table
78835 office rate range by state
State / territoryOffice rate rangeLocalities
AK$101.861
AL$80.231
AR$79.001
AZ$87.431
CA$96.70–$123.5529
CO$94.521
CT$96.021
DC$103.871
DE$88.941
FL$87.12–$94.393
GA$82.10–$91.272
GU$99.491
HI$99.491
IA$83.001
ID$83.441
IL$84.02–$92.714
IN$83.971
KS$82.301
KY$81.611
LA$81.36–$85.652
MA$93.79–$104.622
MD$90.80–$103.873
ME$83.59–$88.822
MI$83.58–$87.962
MN$91.271
MO$79.68–$86.323
MS$79.371
MT$89.851
NC$84.561
ND$89.251
NE$83.571
NH$92.741
NJ$97.32–$102.642
NM$83.951
NV$89.751
NY$85.88–$105.585
OH$83.461
OK$81.761
OR$89.26–$97.992
PA$83.77–$93.332
PR$90.641
RI$92.461
SC$84.111
SD$89.181
TN$82.701
TX$83.16–$94.038
UT$85.341
VA$88.30–$103.872
VI$90.641
VT$88.621
WA$93.70–$107.112
WI$86.071
WV$80.651
WY$89.591

How the 78835 rate is calculated

Each of 78835’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 · 78835

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.46Practice expense 2.20Malpractice 0.03

2.6900 adjusted RVUs×$33.4009 conversion factor=$89.85

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

Payment rules and modifiers for 78835

The CMS indicators that decide how 78835 is paid alongside other services.

CMS payment indicators · 78835

Radiopharmaceutical quantification

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
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

78835 without 26 · national office

$89.85

Radiopharmaceutical quantification

78835-26 · Professional component

$21.38

Pays only the interpretation and report.

When to use modifier 26

78835 compared with similar codes

Compare codes

78835 vs 78800 vs 78803 vs 78830: national Medicare rates

Swap in your local Medicare rate.

  • 78835
    Radiopharmaceutical quantification · 0.46 wRVU
    $89.85
  • 78800
    Tumor imaging · 0.62 wRVU
    $231.80+$141.95
  • 78803
    Tumor SPECT · 1.06 wRVU
    $335.68+$245.83
  • 78830
    Tumor SPECT/CT · 1.45 wRVU
    $420.85+$331.00

How to choose

78800Tumor imaging
78800 reports the limited-area planar localization study. Use 78835 as an add-on only when a defined area from an eligible primary study is quantitatively measured.
78803Tumor SPECT
78803 reports SPECT tumor localization, while 78835 reports quantitative measurement of activity in an area alongside an eligible localization study.
78830Tumor SPECT/CT
78830 reports SPECT/CT tumor localization in one area. It describes the primary imaging service, not the additional quantification captured by 78835.

78835 billing questions

When is 78835 reported with a localization study?

Report it when a related radiopharmaceutical localization study includes quantitative measurement of activity in a specific area. It supplements the primary imaging service rather than replacing it.

How many units should be reported?

Report one unit for each single area quantified. The documentation should identify each measured organ, lesion, or region.

Can 78835 be billed by itself?

No. It is an add-on code and must be billed with an eligible primary radiopharmaceutical localization procedure.

Which modifiers identify the components?

Use modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.

What documentation supports this code?

Document the primary localization study, the area or areas quantified, the measurement results, and the physician’s interpretation.

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 78835PPRRVU2026_Oct_nonQPP.csv, line 9,555 (RVU26D)

Open CMS sourceHow we calculate rates

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