FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

78804 in Austin

Office / nonfacility

$591.10

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Nuclear medicine

About 78804: Whole-body tumor localization over multiple days

Reports whole-body radiopharmaceutical tumor-localization imaging when image acquisition extends across two or more days for the diagnostic study.

This code represents a nuclear medicine tumor-localization study in which a radiopharmaceutical is used to identify tumor-related activity throughout the body, with imaging performed on at least two days. Nuclear medicine technologists acquire the images, and a qualified physician interprets them. The service is typically performed in a hospital or outpatient nuclear medicine department when the diagnostic protocol calls for delayed or serial whole-body imaging rather than a single-day acquisition.

Select the code based on whole-body coverage and the multi-day imaging protocol, not simply the number of images. Documentation should identify the clinical indication, radiopharmaceutical, body coverage, imaging dates or timepoints, and the physician’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff portion, or neither modifier for the global service.

CMS billing rules for 78804

Professional and technical components
Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.

Where the value comes from

  • Work RVU0.98 · 6%
  • Practice expense (office) RVU15.69 · 93%
  • Malpractice RVU0.13 · 1%

807

Medicare services in 2024 · #3141 by national volume

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.

78804 compared with similar codes

Office rates for Austin, from the same CMS release.

78802

Tumor imaging

Whole body, single day

$283.97

Both describe whole-body tumor-localization imaging. Choose 78804 when imaging spans two or more days and 78802 when the study is performed on one day.

78800

Tumor imaging

Single area, one day

$243.51

78800 is for one body area; 78804 is for whole-body imaging performed over two or more days.

78803

Tumor SPECT

Single body area

$352.59

78803 identifies SPECT tumor-localization imaging. Choose 78804 for a multi-day whole-body study when the service is not reported as the SPECT procedure.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 78804 is $513.66—$77.44 lower than the $591.10 rate in Austin. Both use the same code, release and participation basis.

78804 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $591.10

  2. Beaumont

    $513.66

    $77.44 lower than Austin

  3. Brazoria

    $555.73

    $35.37 lower than Austin

  4. Dallas

    $558.72

    $32.38 lower than Austin

  5. Fort Worth

    $553.53

    $37.57 lower than Austin

  6. Galveston

    $556.98

    $34.12 lower than Austin

  7. Houston

    $559.36

    $31.74 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 78804 ranges from $485.14 in Arkansas to $794.36 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 78804

    Office

    $533.99

    Facility

    Unavailable

    $57.11 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 78804

    Office

    $656.92

    Facility

    Unavailable

    $65.82 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 78804

    Office

    $656.68

    Facility

    Unavailable

    $65.58 higher than Austin for the office setting.

  • Miami

    Florida · 78804

    Office

    $589.26

    Facility

    Unavailable

    $1.84 lower than Austin for the office setting.

  • Chicago

    Illinois · 78804

    Office

    $569.61

    Facility

    Unavailable

    $21.49 lower than Austin for the office setting.

  • Manhattan

    New York · 78804

    Office

    $650.67

    Facility

    Unavailable

    $59.57 higher than Austin for the office setting.

  • Alaska*

    Alaska · 78804

    Office

    $609.62

    Facility

    Unavailable

    $18.52 higher than Austin for the office setting.

  • Alabama

    Alabama · 78804

    Office

    $493.74

    Facility

    Unavailable

    $97.36 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 78804

    Office

    $485.14

    Facility

    Unavailable

    $105.96 lower than Austin for the office setting.

  • Arizona

    Arizona · 78804

    Office

    $544.26

    Facility

    Unavailable

    $46.84 lower than Austin for the office setting.

  • Bakersfield

    California · 78804

    Office

    $610.37

    Facility

    Unavailable

    $19.27 higher than Austin for the office setting.

  • Chico

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • El Centro

    California · 78804

    Office

    $610.01

    Facility

    Unavailable

    $18.91 higher than Austin for the office setting.

  • Fresno

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Madera

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Merced

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Modesto

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Napa

    California · 78804

    Office

    $727.71

    Facility

    Unavailable

    $136.61 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 78804

    Office

    $655.79

    Facility

    Unavailable

    $64.69 higher than Austin for the office setting.

  • Redding

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Rest Of California

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 78804

    Office

    $611.40

    Facility

    Unavailable

    $20.30 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 78804

    Office

    $645.72

    Facility

    Unavailable

    $54.62 higher than Austin for the office setting.

  • Salinas

    California · 78804

    Office

    $643.46

    Facility

    Unavailable

    $52.36 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 78804

    Office

    $662.84

    Facility

    Unavailable

    $71.74 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 78804

    Office

    $776.76

    Facility

    Unavailable

    $185.66 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 78804

    Office

    $776.61

    Facility

    Unavailable

    $185.51 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 78804

    Office

    $794.36

    Facility

    Unavailable

    $203.26 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 78804

    Office

    $793.75

    Facility

    Unavailable

    $202.65 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 78804

    Office

    $632.52

    Facility

    Unavailable

    $41.42 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 78804

    Office

    $672.48

    Facility

    Unavailable

    $81.38 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 78804

    Office

    $647.03

    Facility

    Unavailable

    $55.93 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 78804

    Office

    $679.59

    Facility

    Unavailable

    $88.49 higher than Austin for the office setting.

  • Stockton

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Vallejo

    California · 78804

    Office

    $727.50

    Facility

    Unavailable

    $136.40 higher than Austin for the office setting.

  • Visalia

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Yuba City

    California · 78804

    Office

    $609.99

    Facility

    Unavailable

    $18.89 higher than Austin for the office setting.

  • Colorado

    Colorado · 78804

    Office

    $594.12

    Facility

    Unavailable

    $3.02 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 78804

    Office

    $603.05

    Facility

    Unavailable

    $11.95 higher than Austin for the office setting.

  • Delaware

    Delaware · 78804

    Office

    $554.57

    Facility

    Unavailable

    $36.53 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 78804

    Office

    $571.46

    Facility

    Unavailable

    $19.64 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 78804

    Office

    $540.26

    Facility

    Unavailable

    $50.84 lower than Austin for the office setting.

  • Atlanta

    Georgia · 78804

    Office

    $570.49

    Facility

    Unavailable

    $20.61 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 78804

    Office

    $505.37

    Facility

    Unavailable

    $85.73 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 78804

    Office

    $631.10

    Facility

    Unavailable

    $40.00 higher than Austin for the office setting.

  • Iowa

    Iowa · 78804

    Office

    $513.97

    Facility

    Unavailable

    $77.13 lower than Austin for the office setting.

  • Idaho

    Idaho · 78804

    Office

    $516.92

    Facility

    Unavailable

    $74.18 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 78804

    Office

    $523.61

    Facility

    Unavailable

    $67.49 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 78804

    Office

    $517.99

    Facility

    Unavailable

    $73.11 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 78804

    Office

    $578.87

    Facility

    Unavailable

    $12.23 lower than Austin for the office setting.

  • Indiana

    Indiana · 78804

    Office

    $520.65

    Facility

    Unavailable

    $70.45 lower than Austin for the office setting.

  • Kansas

    Kansas · 78804

    Office

    $508.67

    Facility

    Unavailable

    $82.43 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 78804

    Office

    $502.60

    Facility

    Unavailable

    $88.50 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 78804

    Office

    $530.81

    Facility

    Unavailable

    $60.29 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 78804

    Office

    $500.69

    Facility

    Unavailable

    $90.41 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 78804

    Office

    $663.67

    Facility

    Unavailable

    $72.57 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 78804

    Office

    $588.55

    Facility

    Unavailable

    $2.55 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 78804

    Office

    $600.94

    Facility

    Unavailable

    $9.84 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 78804

    Office

    $567.40

    Facility

    Unavailable

    $23.70 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 78804

    Office

    $517.57

    Facility

    Unavailable

    $73.53 lower than Austin for the office setting.

  • Southern Maine

    Maine · 78804

    Office

    $554.82

    Facility

    Unavailable

    $36.28 lower than Austin for the office setting.

  • Detroit

    Michigan · 78804

    Office

    $545.77

    Facility

    Unavailable

    $45.33 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 78804

    Office

    $516.10

    Facility

    Unavailable

    $75.00 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 78804

    Office

    $573.28

    Facility

    Unavailable

    $17.82 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 78804

    Office

    $529.07

    Facility

    Unavailable

    $62.03 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 78804

    Office

    $535.99

    Facility

    Unavailable

    $55.11 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 78804

    Office

    $488.70

    Facility

    Unavailable

    $102.40 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 78804

    Office

    $487.16

    Facility

    Unavailable

    $103.94 lower than Austin for the office setting.

  • Montana**

    Montana · 78804

    Office

    $561.13

    Facility

    Unavailable

    $29.97 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 78804

    Office

    $524.46

    Facility

    Unavailable

    $66.64 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 78804

    Office

    $558.56

    Facility

    Unavailable

    $32.54 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 78804

    Office

    $518.08

    Facility

    Unavailable

    $73.02 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 78804

    Office

    $582.08

    Facility

    Unavailable

    $9.02 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 78804

    Office

    $647.34

    Facility

    Unavailable

    $56.24 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 78804

    Office

    $611.08

    Facility

    Unavailable

    $19.98 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 78804

    Office

    $518.51

    Facility

    Unavailable

    $72.59 lower than Austin for the office setting.

  • Nevada**

    Nevada · 78804

    Office

    $560.93

    Facility

    Unavailable

    $30.17 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 78804

    Office

    $666.00

    Facility

    Unavailable

    $74.90 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 78804

    Office

    $613.31

    Facility

    Unavailable

    $22.21 higher than Austin for the office setting.

  • Queens

    New York · 78804

    Office

    $660.53

    Facility

    Unavailable

    $69.43 higher than Austin for the office setting.

  • Rest Of New York

    New York · 78804

    Office

    $533.64

    Facility

    Unavailable

    $57.46 lower than Austin for the office setting.

  • Ohio

    Ohio · 78804

    Office

    $515.58

    Facility

    Unavailable

    $75.52 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 78804

    Office

    $504.09

    Facility

    Unavailable

    $87.01 lower than Austin for the office setting.

  • Portland

    Oregon · 78804

    Office

    $618.72

    Facility

    Unavailable

    $27.62 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 78804

    Office

    $557.75

    Facility

    Unavailable

    $33.35 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 78804

    Office

    $584.05

    Facility

    Unavailable

    $7.05 lower than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 78804

    Office

    $517.92

    Facility

    Unavailable

    $73.18 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 78804

    Office

    $566.83

    Facility

    Unavailable

    $24.27 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 78804

    Office

    $578.58

    Facility

    Unavailable

    $12.52 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 78804

    Office

    $520.66

    Facility

    Unavailable

    $70.44 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 78804

    Office

    $558.25

    Facility

    Unavailable

    $32.85 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 78804

    Office

    $511.44

    Facility

    Unavailable

    $79.66 lower than Austin for the office setting.

  • Utah

    Utah · 78804

    Office

    $529.25

    Facility

    Unavailable

    $61.85 lower than Austin for the office setting.

  • Virginia

    Virginia · 78804

    Office

    $550.95

    Facility

    Unavailable

    $40.15 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 78804

    Office

    $566.83

    Facility

    Unavailable

    $24.27 lower than Austin for the office setting.

  • Vermont

    Vermont · 78804

    Office

    $553.75

    Facility

    Unavailable

    $37.35 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 78804

    Office

    $588.30

    Facility

    Unavailable

    $2.80 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 78804

    Office

    $680.94

    Facility

    Unavailable

    $89.84 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 78804

    Office

    $536.12

    Facility

    Unavailable

    $54.98 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 78804

    Office

    $494.35

    Facility

    Unavailable

    $96.75 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 78804

    Office

    $560.01

    Facility

    Unavailable

    $31.09 lower than Austin for the office setting.

See how rates vary across the country

78804 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$485.14

$702.18

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$609.621
AL$493.741
AR$485.141
AZ$544.261
CA$609.99–$794.3629
CO$594.121
CT$603.051
DC$656.681
DE$554.571
FL$540.26–$589.263
GA$505.37–$570.492
GU$631.101
HI$631.101
IA$513.971
ID$516.921
IL$517.99–$578.874
IN$520.651
KS$508.671
KY$502.601
LA$500.69–$530.812
MA$588.55–$663.672
MD$567.40–$656.683
ME$517.57–$554.822
MI$516.10–$545.772
MN$573.281
MO$488.70–$535.993
MS$487.161
MT$561.131
NC$524.461
ND$558.561
NE$518.081
NH$582.081
NJ$611.08–$647.342
NM$518.511
NV$560.931
NY$533.64–$666.005
OH$515.581
OK$504.091
OR$557.75–$618.722
PA$517.92–$584.052
PR$566.831
RI$578.581
SC$520.661
SD$558.251
TN$511.441
TX$513.66–$591.108
UT$529.251
VA$550.95–$656.682
VI$566.831
VT$553.751
WA$588.30–$680.942
WI$536.121
WV$494.351
WY$560.011

Explore 78804 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 78804 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$650.21

$591.10 × 110% = $650.21

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 78804 in Austin.

PPRRVU2026_Oct_nonQPP.csv

9,524

Code
78804
Physician work
0.98
Practice expense
15.69
Malpractice
0.13

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 78804 in Austin
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0020.9820
Practice expense15.69× 1.05816.6000
Malpractice0.13× 0.8860.1152
Total RVUs17.6972
Conversion factor× 33.4009

Office / nonfacility rate, Austin$591.10

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 78804 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.981.002
Practice expense15.691.058
Malpractice0.130.886

(0.98 × 1.002 + 15.69 × 1.058 + 0.13 × 0.886) × $33.4009 = $591.10

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

78804 · Office / nonfacility

$591.10

Effective 2026-10-01

The base rate is $14.88 higher than on 2025-10-01, moving from $576.22 to $591.10 (2.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $576.22changed to$591.10

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.01 changed to 0.98
    • Practice expense RVU 15.96 changed to 15.69
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $576.22

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$591.10Not available in this settingRVU26D
2026-07-01$591.10Not available in this settingRVU26C
2026-04-01$591.10Not available in this settingRVU26B
2026-01-01$591.10Not available in this settingRVU26A
2025-10-01$576.22Not available in this settingRVU25D
2025-07-01$576.22Not available in this settingRVU25C
2025-04-01$576.22Not available in this settingRVU25B
2025-01-01$576.22Not available in this settingRVU25A

78804 billing questions

How does this differ from 78802?

78804 is for whole-body tumor-localization imaging performed over two or more days. Use 78802 when the whole-body study is completed on one day.

When should I choose 78800 or 78801 instead?

Those codes describe tumor-localization imaging of one area or multiple areas, rather than whole-body imaging. Choose according to the documented body coverage.

Can the professional and technical portions be billed separately?

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

What documentation supports 78804?

Document the whole-body coverage, radiopharmaceutical, clinical indication, image-acquisition dates or timepoints, and the interpreting physician’s findings.

Is 78804 the right code for SPECT tumor imaging?

Use the applicable SPECT tumor-localization code when the service is SPECT-based. 78804 identifies a multi-day whole-body study, not SPECT imaging.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 78804PPRRVU2026_Oct_nonQPP.csv, line 9,524 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet