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CMS RVU26D · Effective 2026-10-01

78130 in El Centro

Office / nonfacility

$136.25

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 78130: Red blood cell survival study

Reports a nuclear medicine study that tracks labeled red blood cells over time to assess their survival in patients with suspected shortened erythrocyte lifespan.

For this study, the patient’s red blood cells are labeled and returned to circulation, then evaluated through follow-up sampling to estimate how long they survive. It is used in investigations of suspected hemolysis or other causes of shortened red-cell lifespan. Nuclear medicine personnel perform the technical work, and a qualified physician interprets the results. The service may be provided through a hospital or other diagnostic testing setting that can manage cell labeling and serial assessment.

Report 78130 when the documented service evaluates red-cell survival, not simply red-cell quantity or the location of cell sequestration. The record should support the labeling and administration of the cells, the survival assessment, and the physician’s interpretation and report. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the interpretation, modifier TC for the technical service, or neither modifier for the global service when one entity provides both components.

CMS billing rules for 78130

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 RVU0.59 · 16%
  • Practice expense (office) RVU3.14 · 83%
  • Malpractice RVU0.07 · 2%

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.

78130 compared with similar codes

Office rates for El Centro, from the same CMS release.

78140

Red-cell study

Splenic sequestration

$117.95

78130 evaluates how long red cells survive; 78140 evaluates red-cell sequestration. Use the code for the study actually performed and documented.

78120

Red cell mass

Single determination

$77.93

78120 measures red-cell mass in a single determination. Choose 78130 when the test evaluates red-cell lifespan instead of the circulating red-cell quantity.

78191

Platelet study

Platelet survival

$136.25

78191 evaluates platelet survival, while 78130 evaluates red-cell survival. The cell type studied determines the code.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 78130 is $136.45—$0.20 higher than the $136.25 rate in El Centro. Both use the same code, release and participation basis.

78130 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $136.25

  2. Bakersfield

    $136.45

    $0.20 higher than El Centro

  3. Chico

    $136.24

    $0.01 lower than El Centro

  4. Fresno

    $136.24

    $0.01 lower than El Centro

  5. Hanford-Corcoran

    $136.24

    $0.01 lower than El Centro

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $146.14

    $9.89 higher than El Centro

  7. Madera

    $136.24

    $0.01 lower than El Centro

Other payment areas listed in California 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, 78130 ranges from $111.00 in Arkansas to $174.36 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

  • Merced

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Modesto

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Napa

    California · 78130

    Office

    $160.37

    Facility

    Unavailable

    $24.12 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 78130

    Office

    $145.68

    Facility

    Unavailable

    $9.43 higher than El Centro for the office setting.

  • Redding

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Rest Of California

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 78130

    Office

    $137.00

    Facility

    Unavailable

    $0.75 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 78130

    Office

    $143.64

    Facility

    Unavailable

    $7.39 higher than El Centro for the office setting.

  • Salinas

    California · 78130

    Office

    $143.13

    Facility

    Unavailable

    $6.88 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 78130

    Office

    $147.00

    Facility

    Unavailable

    $10.75 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 78130

    Office

    $170.53

    Facility

    Unavailable

    $34.28 higher than El Centro for the office setting.

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

    California · 78130

    Office

    $170.45

    Facility

    Unavailable

    $34.20 higher than El Centro for the office setting.

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

    California · 78130

    Office

    $174.36

    Facility

    Unavailable

    $38.11 higher than El Centro for the office setting.

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

    California · 78130

    Office

    $174.04

    Facility

    Unavailable

    $37.79 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 78130

    Office

    $140.75

    Facility

    Unavailable

    $4.50 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 78130

    Office

    $148.80

    Facility

    Unavailable

    $12.55 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 78130

    Office

    $143.80

    Facility

    Unavailable

    $7.55 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 78130

    Office

    $150.34

    Facility

    Unavailable

    $14.09 higher than El Centro for the office setting.

  • Stockton

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Vallejo

    California · 78130

    Office

    $160.25

    Facility

    Unavailable

    $24.00 higher than El Centro for the office setting.

  • Visalia

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Yuba City

    California · 78130

    Office

    $136.24

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 78130

    Office

    $146.92

    Facility

    Unavailable

    $10.67 higher than El Centro for the office setting.

  • Miami

    Florida · 78130

    Office

    $134.80

    Facility

    Unavailable

    $1.45 lower than El Centro for the office setting.

  • Chicago

    Illinois · 78130

    Office

    $130.61

    Facility

    Unavailable

    $5.64 lower than El Centro for the office setting.

  • Manhattan

    New York · 78130

    Office

    $146.55

    Facility

    Unavailable

    $10.30 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 78130

    Office

    $142.54

    Facility

    Unavailable

    $6.29 higher than El Centro for the office setting.

  • Alabama

    Alabama · 78130

    Office

    $112.80

    Facility

    Unavailable

    $23.45 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 78130

    Office

    $111.00

    Facility

    Unavailable

    $25.25 lower than El Centro for the office setting.

  • Arizona

    Arizona · 78130

    Office

    $123.34

    Facility

    Unavailable

    $12.91 lower than El Centro for the office setting.

  • Colorado

    Colorado · 78130

    Office

    $133.36

    Facility

    Unavailable

    $2.89 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 78130

    Office

    $135.88

    Facility

    Unavailable

    $0.37 lower than El Centro for the office setting.

  • Delaware

    Delaware · 78130

    Office

    $125.53

    Facility

    Unavailable

    $10.72 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 78130

    Office

    $130.18

    Facility

    Unavailable

    $6.07 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 78130

    Office

    $123.48

    Facility

    Unavailable

    $12.77 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 78130

    Office

    $129.13

    Facility

    Unavailable

    $7.12 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 78130

    Office

    $116.05

    Facility

    Unavailable

    $20.20 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 78130

    Office

    $140.31

    Facility

    Unavailable

    $4.06 higher than El Centro for the office setting.

  • Iowa

    Iowa · 78130

    Office

    $116.60

    Facility

    Unavailable

    $19.65 lower than El Centro for the office setting.

  • Idaho

    Idaho · 78130

    Office

    $117.30

    Facility

    Unavailable

    $18.95 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 78130

    Office

    $120.90

    Facility

    Unavailable

    $15.35 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 78130

    Office

    $119.12

    Facility

    Unavailable

    $17.13 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 78130

    Office

    $131.70

    Facility

    Unavailable

    $4.55 lower than El Centro for the office setting.

  • Indiana

    Indiana · 78130

    Office

    $118.07

    Facility

    Unavailable

    $18.18 lower than El Centro for the office setting.

  • Kansas

    Kansas · 78130

    Office

    $115.70

    Facility

    Unavailable

    $20.55 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 78130

    Office

    $115.08

    Facility

    Unavailable

    $21.17 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 78130

    Office

    $121.05

    Facility

    Unavailable

    $15.20 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 78130

    Office

    $114.76

    Facility

    Unavailable

    $21.49 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 78130

    Office

    $147.82

    Facility

    Unavailable

    $11.57 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 78130

    Office

    $132.32

    Facility

    Unavailable

    $3.93 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 78130

    Office

    $135.45

    Facility

    Unavailable

    $0.80 lower than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 78130

    Office

    $128.19

    Facility

    Unavailable

    $8.06 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 78130

    Office

    $117.65

    Facility

    Unavailable

    $18.60 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 78130

    Office

    $125.12

    Facility

    Unavailable

    $11.13 lower than El Centro for the office setting.

  • Detroit

    Michigan · 78130

    Office

    $124.86

    Facility

    Unavailable

    $11.39 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 78130

    Office

    $118.10

    Facility

    Unavailable

    $18.15 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 78130

    Office

    $128.32

    Facility

    Unavailable

    $7.93 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 78130

    Office

    $120.47

    Facility

    Unavailable

    $15.78 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 78130

    Office

    $121.89

    Facility

    Unavailable

    $14.36 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 78130

    Office

    $112.39

    Facility

    Unavailable

    $23.86 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 78130

    Office

    $111.74

    Facility

    Unavailable

    $24.51 lower than El Centro for the office setting.

  • Montana**

    Montana · 78130

    Office

    $126.92

    Facility

    Unavailable

    $9.33 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 78130

    Office

    $119.05

    Facility

    Unavailable

    $17.20 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 78130

    Office

    $125.53

    Facility

    Unavailable

    $10.72 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 78130

    Office

    $117.39

    Facility

    Unavailable

    $18.86 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 78130

    Office

    $130.93

    Facility

    Unavailable

    $5.32 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 78130

    Office

    $145.10

    Facility

    Unavailable

    $8.85 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 78130

    Office

    $137.59

    Facility

    Unavailable

    $1.34 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 78130

    Office

    $118.69

    Facility

    Unavailable

    $17.56 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 78130

    Office

    $126.64

    Facility

    Unavailable

    $9.61 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 78130

    Office

    $150.01

    Facility

    Unavailable

    $13.76 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 78130

    Office

    $138.26

    Facility

    Unavailable

    $2.01 higher than El Centro for the office setting.

  • Queens

    New York · 78130

    Office

    $148.31

    Facility

    Unavailable

    $12.06 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 78130

    Office

    $120.99

    Facility

    Unavailable

    $15.26 lower than El Centro for the office setting.

  • Ohio

    Ohio · 78130

    Office

    $117.82

    Facility

    Unavailable

    $18.43 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 78130

    Office

    $115.18

    Facility

    Unavailable

    $21.07 lower than El Centro for the office setting.

  • Portland

    Oregon · 78130

    Office

    $138.28

    Facility

    Unavailable

    $2.03 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 78130

    Office

    $125.81

    Facility

    Unavailable

    $10.44 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 78130

    Office

    $132.03

    Facility

    Unavailable

    $4.22 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 78130

    Office

    $118.19

    Facility

    Unavailable

    $18.06 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 78130

    Office

    $128.04

    Facility

    Unavailable

    $8.21 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 78130

    Office

    $130.51

    Facility

    Unavailable

    $5.74 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 78130

    Office

    $118.60

    Facility

    Unavailable

    $17.65 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 78130

    Office

    $125.37

    Facility

    Unavailable

    $10.88 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 78130

    Office

    $116.30

    Facility

    Unavailable

    $19.95 lower than El Centro for the office setting.

  • Austin

    Texas · 78130

    Office

    $132.78

    Facility

    Unavailable

    $3.47 lower than El Centro for the office setting.

  • Beaumont

    Texas · 78130

    Office

    $117.32

    Facility

    Unavailable

    $18.93 lower than El Centro for the office setting.

  • Brazoria

    Texas · 78130

    Office

    $125.62

    Facility

    Unavailable

    $10.63 lower than El Centro for the office setting.

  • Dallas

    Texas · 78130

    Office

    $126.35

    Facility

    Unavailable

    $9.90 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 78130

    Office

    $125.33

    Facility

    Unavailable

    $10.92 lower than El Centro for the office setting.

  • Galveston

    Texas · 78130

    Office

    $125.94

    Facility

    Unavailable

    $10.31 lower than El Centro for the office setting.

  • Houston

    Texas · 78130

    Office

    $127.23

    Facility

    Unavailable

    $9.02 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 78130

    Office

    $121.35

    Facility

    Unavailable

    $14.90 lower than El Centro for the office setting.

  • Utah

    Utah · 78130

    Office

    $120.39

    Facility

    Unavailable

    $15.86 lower than El Centro for the office setting.

  • Virginia

    Virginia · 78130

    Office

    $124.45

    Facility

    Unavailable

    $11.80 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 78130

    Office

    $128.04

    Facility

    Unavailable

    $8.21 lower than El Centro for the office setting.

  • Vermont

    Vermont · 78130

    Office

    $124.72

    Facility

    Unavailable

    $11.53 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 78130

    Office

    $132.18

    Facility

    Unavailable

    $4.07 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 78130

    Office

    $151.29

    Facility

    Unavailable

    $15.04 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 78130

    Office

    $120.90

    Facility

    Unavailable

    $15.35 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 78130

    Office

    $114.19

    Facility

    Unavailable

    $22.06 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 78130

    Office

    $126.32

    Facility

    Unavailable

    $9.93 lower than El Centro for the office setting.

See how rates vary across the country

78130 · 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.

$111.00

$155.30

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$142.541
AL$112.801
AR$111.001
AZ$123.341
CA$136.24–$174.3629
CO$133.361
CT$135.881
DC$146.921
DE$125.531
FL$123.48–$134.803
GA$116.05–$129.132
GU$140.311
HI$140.311
IA$116.601
ID$117.301
IL$119.12–$131.704
IN$118.071
KS$115.701
KY$115.081
LA$114.76–$121.052
MA$132.32–$147.822
MD$128.19–$146.923
ME$117.65–$125.122
MI$118.10–$124.862
MN$128.321
MO$112.39–$121.893
MS$111.741
MT$126.921
NC$119.051
ND$125.531
NE$117.391
NH$130.931
NJ$137.59–$145.102
NM$118.691
NV$126.641
NY$120.99–$150.015
OH$117.821
OK$115.181
OR$125.81–$138.282
PA$118.19–$132.032
PR$128.041
RI$130.511
SC$118.601
SD$125.371
TN$116.301
TX$117.32–$132.788
UT$120.391
VA$124.45–$146.922
VI$128.041
VT$124.721
WA$132.18–$151.292
WI$120.901
WV$114.191
WY$126.321

Explore 78130 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, 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 California →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 78130 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$149.88

$136.25 × 110% = $149.88

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 78130 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

9,239

Code
78130
Physician work
0.59
Practice expense
3.14
Malpractice
0.07

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 78130 in El Centro
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0170.6000
Practice expense3.14× 1.0963.4414
Malpractice0.07× 0.5410.0379
Total RVUs4.0793
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$136.25

Open 78130 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.591.017
Practice expense3.141.096
Malpractice0.070.541

(0.59 × 1.017 + 3.14 × 1.096 + 0.07 × 0.541) × $33.4009 = $136.25

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

78130 · Office / nonfacility

$136.25

Effective 2026-10-01

The base rate is $6.95 higher than on 2025-10-01, moving from $129.30 to $136.25 (5.4%).

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

    $129.30changed to$136.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.61 changed to 0.59
    • Practice expense RVU 3.06 changed to 3.14
    • Malpractice RVU 0.06 changed to 0.07
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $129.30

    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$136.25Not available in this settingRVU26D
2026-07-01$136.25Not available in this settingRVU26C
2026-04-01$136.25Not available in this settingRVU26B
2026-01-01$136.25Not available in this settingRVU26A
2025-10-01$129.30Not available in this settingRVU25D
2025-07-01$129.30Not available in this settingRVU25C
2025-04-01$129.30Not available in this settingRVU25B
2025-01-01$129.30Not available in this settingRVU25A

78130 billing questions

How is 78130 different from a red-cell mass study?

78130 evaluates how long circulating red cells survive. Red-cell mass testing measures the amount of red-cell volume rather than cell lifespan.

When should modifier 26 or TC be used?

Use modifier 26 for the physician’s interpretation and report, and TC for the technical service. Report the global service without either modifier when both components are billed together.

Does 78130 include a red-cell sequestration study?

The survival assessment and sequestration assessment address different findings. Report 78130 for the survival work performed; the documentation should identify any separately performed sequestration study.

What documentation supports reporting 78130?

Document the red-cell labeling and administration, the survival assessment, and the interpretation. The record should establish that the test evaluates red-cell lifespan rather than mass alone.

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 78130PPRRVU2026_Oct_nonQPP.csv, line 9,239 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet