Use 78740 for the radionuclide reflux examination; 74455 is the fluoroscopic voiding cystourethrography service.
On this page
CMS RVU26D · Effective 2026-10-01
78740 in Merced
Office / nonfacility
$239.37
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 78740: Radionuclide ureteral reflux study
Reports radionuclide imaging of the bladder and upper urinary tract to evaluate suspected urine reflux from the bladder into the ureters.
This nuclear medicine study evaluates whether urine flows backward from the bladder into the ureters, and sometimes toward the kidneys. A radiopharmaceutical is introduced into the bladder and images are obtained during filling and voiding. It is commonly used when vesicoureteral reflux is suspected, including in the evaluation of recurrent urinary tract infections, and may be performed in a nuclear medicine or radiology department. A nuclear medicine physician or radiologist interprets the images.
Select this code when the documented examination is a radionuclide ureteral reflux study, rather than imaging focused on renal drainage or bladder emptying. The record should support the reflux question and the imaging performed. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment-and-staff service; an unmodified claim represents the global service, including both components. CMS separately prices the 26 and TC components.
CMS billing rules for 78740
- 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 RVU0.56 · 8%
- Practice expense (office) RVU5.99 · 91%
- Malpractice RVU0.06 · 1%
90
Medicare services in 2024 · #4965 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.
78740 compared with similar codes
Office rates for Merced, from the same CMS release.
78708 evaluates renal flow and function with a pharmacologic intervention; 78740 evaluates reflux from the bladder into the ureters.
78730 is a urinary bladder retention study. Choose 78740 when the diagnostic question is ureteral reflux, not retained bladder volume.
The same code, a different location
How does Merced compare?
In Bakersfield, the office rate for 78740 is $239.56—$0.19 higher than the $239.37 rate in Merced. Both use the same code, release and participation basis.
78740 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
$239.37
$239.56
$0.19 higher than Merced
$239.37
The same base rate than Merced
$239.38
$0.01 higher than Merced
$239.37
The same base rate than Merced
$239.37
The same base rate than Merced
$18.12 higher than Merced
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, 78740 ranges from $191.60 in Arkansas to $310.34 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
Madera
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Modesto
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Napa
California · 78740
Office
$284.60
Facility
Unavailable
$45.23 higher than Merced for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 78740
Office
$256.96
Facility
Unavailable
$17.59 higher than Merced for the office setting.
Redding
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Rest Of California
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Riverside-San Bernardino-Ontario
California · 78740
Office
$240.03
Facility
Unavailable
$0.66 higher than Merced for the office setting.
Sacramento-Roseville-Folsom
California · 78740
Office
$253.14
Facility
Unavailable
$13.77 higher than Merced for the office setting.
Salinas
California · 78740
Office
$252.24
Facility
Unavailable
$12.87 higher than Merced for the office setting.
San Diego-Chula Vista-Carlsbad
California · 78740
Office
$259.64
Facility
Unavailable
$20.27 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 78740
Office
$303.50
Facility
Unavailable
$64.13 higher than Merced for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 78740
Office
$303.43
Facility
Unavailable
$64.06 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 78740
Office
$310.34
Facility
Unavailable
$70.97 higher than Merced for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 78740
Office
$310.06
Facility
Unavailable
$70.69 higher than Merced for the office setting.
San Luis Obispo-Paso Robles
California · 78740
Office
$247.98
Facility
Unavailable
$8.61 higher than Merced for the office setting.
Santa Cruz-Watsonville
California · 78740
Office
$263.26
Facility
Unavailable
$23.89 higher than Merced for the office setting.
Santa Maria-Santa Barbara
California · 78740
Office
$253.59
Facility
Unavailable
$14.22 higher than Merced for the office setting.
Santa Rosa-Petaluma
California · 78740
Office
$266.03
Facility
Unavailable
$26.66 higher than Merced for the office setting.
Stockton
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Vallejo
California · 78740
Office
$284.50
Facility
Unavailable
$45.13 higher than Merced for the office setting.
Visalia
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Yuba City
California · 78740
Office
$239.37
Facility
Unavailable
The same base rate than Merced for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 78740
Office
$257.63
Facility
Unavailable
$18.26 higher than Merced for the office setting.
Miami
Florida · 78740
Office
$232.05
Facility
Unavailable
$7.32 lower than Merced for the office setting.
Chicago
Illinois · 78740
Office
$224.51
Facility
Unavailable
$14.86 lower than Merced for the office setting.
Manhattan
New York · 78740
Office
$255.56
Facility
Unavailable
$16.19 higher than Merced for the office setting.
Alaska*
Alaska · 78740
Office
$242.24
Facility
Unavailable
$2.87 higher than Merced for the office setting.
Alabama
Alabama · 78740
Office
$194.90
Facility
Unavailable
$44.47 lower than Merced for the office setting.
Arkansas
Arkansas · 78740
Office
$191.60
Facility
Unavailable
$47.77 lower than Merced for the office setting.
Arizona
Arizona · 78740
Office
$214.29
Facility
Unavailable
$25.08 lower than Merced for the office setting.
Colorado
Colorado · 78740
Office
$233.37
Facility
Unavailable
$6.00 lower than Merced for the office setting.
Connecticut
Connecticut · 78740
Office
$236.98
Facility
Unavailable
$2.39 lower than Merced for the office setting.
Delaware
Delaware · 78740
Office
$218.27
Facility
Unavailable
$21.10 lower than Merced for the office setting.
Fort Lauderdale
Florida · 78740
Office
$225.00
Facility
Unavailable
$14.37 lower than Merced for the office setting.
Rest Of Florida
Florida · 78740
Office
$212.98
Facility
Unavailable
$26.39 lower than Merced for the office setting.
Atlanta
Georgia · 78740
Office
$224.44
Facility
Unavailable
$14.93 lower than Merced for the office setting.
Rest Of Georgia
Georgia · 78740
Office
$199.56
Facility
Unavailable
$39.81 lower than Merced for the office setting.
Hawaii, Guam
Hawaii · 78740
Office
$247.35
Facility
Unavailable
$7.98 higher than Merced for the office setting.
Iowa
Iowa · 78740
Office
$202.57
Facility
Unavailable
$36.80 lower than Merced for the office setting.
Idaho
Idaho · 78740
Office
$203.72
Facility
Unavailable
$35.65 lower than Merced for the office setting.
East St. Louis
Illinois · 78740
Office
$206.81
Facility
Unavailable
$32.56 lower than Merced for the office setting.
Rest Of Illinois
Illinois · 78740
Office
$204.50
Facility
Unavailable
$34.87 lower than Merced for the office setting.
Suburban Chicago
Illinois · 78740
Office
$227.86
Facility
Unavailable
$11.51 lower than Merced for the office setting.
Indiana
Indiana · 78740
Office
$205.14
Facility
Unavailable
$34.23 lower than Merced for the office setting.
Kansas
Kansas · 78740
Office
$200.58
Facility
Unavailable
$38.79 lower than Merced for the office setting.
Kentucky
Kentucky · 78740
Office
$198.40
Facility
Unavailable
$40.97 lower than Merced for the office setting.
New Orleans
Louisiana · 78740
Office
$209.25
Facility
Unavailable
$30.12 lower than Merced for the office setting.
Rest Of Louisiana
Louisiana · 78740
Office
$197.69
Facility
Unavailable
$41.68 lower than Merced for the office setting.
Metropolitan Boston
Massachusetts · 78740
Office
$260.14
Facility
Unavailable
$20.77 higher than Merced for the office setting.
Rest Of Massachusetts
Massachusetts · 78740
Office
$231.28
Facility
Unavailable
$8.09 lower than Merced for the office setting.
Baltimore/Surr. Cntys
Maryland · 78740
Office
$236.16
Facility
Unavailable
$3.21 lower than Merced for the office setting.
Rest Of Maryland
Maryland · 78740
Office
$223.20
Facility
Unavailable
$16.17 lower than Merced for the office setting.
Rest Of Maine
Maine · 78740
Office
$204.02
Facility
Unavailable
$35.35 lower than Merced for the office setting.
Southern Maine
Maine · 78740
Office
$218.24
Facility
Unavailable
$21.13 lower than Merced for the office setting.
Detroit
Michigan · 78740
Office
$215.15
Facility
Unavailable
$24.22 lower than Merced for the office setting.
Rest Of Michigan
Michigan · 78740
Office
$203.63
Facility
Unavailable
$35.74 lower than Merced for the office setting.
Minnesota
Minnesota · 78740
Office
$225.17
Facility
Unavailable
$14.20 lower than Merced for the office setting.
Metropolitan Kansas City
Missouri · 78740
Office
$208.53
Facility
Unavailable
$30.84 lower than Merced for the office setting.
Metropolitan St. Louis
Missouri · 78740
Office
$211.18
Facility
Unavailable
$28.19 lower than Merced for the office setting.
Rest Of Missouri
Missouri · 78740
Office
$193.12
Facility
Unavailable
$46.25 lower than Merced for the office setting.
Mississippi
Mississippi · 78740
Office
$192.45
Facility
Unavailable
$46.92 lower than Merced for the office setting.
Montana**
Montana · 78740
Office
$220.78
Facility
Unavailable
$18.59 lower than Merced for the office setting.
North Carolina
North Carolina · 78740
Office
$206.65
Facility
Unavailable
$32.72 lower than Merced for the office setting.
North Dakota**
North Dakota · 78740
Office
$219.59
Facility
Unavailable
$19.78 lower than Merced for the office setting.
Nebraska
Nebraska · 78740
Office
$204.13
Facility
Unavailable
$35.24 lower than Merced for the office setting.
New Hampshire
New Hampshire · 78740
Office
$228.73
Facility
Unavailable
$10.64 lower than Merced for the office setting.
Northern Nj
New Jersey · 78740
Office
$254.11
Facility
Unavailable
$14.74 higher than Merced for the office setting.
Rest Of New Jersey
New Jersey · 78740
Office
$240.13
Facility
Unavailable
$0.76 higher than Merced for the office setting.
New Mexico
New Mexico · 78740
Office
$204.58
Facility
Unavailable
$34.79 lower than Merced for the office setting.
Nevada**
Nevada · 78740
Office
$220.65
Facility
Unavailable
$18.72 lower than Merced for the office setting.
Nyc Suburbs/Long Island
New York · 78740
Office
$261.51
Facility
Unavailable
$22.14 higher than Merced for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 78740
Office
$241.05
Facility
Unavailable
$1.68 higher than Merced for the office setting.
Queens
New York · 78740
Office
$259.28
Facility
Unavailable
$19.91 higher than Merced for the office setting.
Rest Of New York
New York · 78740
Office
$210.18
Facility
Unavailable
$29.19 lower than Merced for the office setting.
Ohio
Ohio · 78740
Office
$203.39
Facility
Unavailable
$35.98 lower than Merced for the office setting.
Oklahoma
Oklahoma · 78740
Office
$198.93
Facility
Unavailable
$40.44 lower than Merced for the office setting.
Portland
Oregon · 78740
Office
$242.77
Facility
Unavailable
$3.40 higher than Merced for the office setting.
Rest Of Oregon
Oregon · 78740
Office
$219.38
Facility
Unavailable
$19.99 lower than Merced for the office setting.
Metropolitan Philadelphia
Pennsylvania · 78740
Office
$229.71
Facility
Unavailable
$9.66 lower than Merced for the office setting.
Rest Of Pennsylvania
Pennsylvania · 78740
Office
$204.26
Facility
Unavailable
$35.11 lower than Merced for the office setting.
Puerto Rico
Puerto Rico · 78740
Office
$222.95
Facility
Unavailable
$16.42 lower than Merced for the office setting.
Rhode Island
Rhode Island · 78740
Office
$227.52
Facility
Unavailable
$11.85 lower than Merced for the office setting.
South Carolina
South Carolina · 78740
Office
$205.27
Facility
Unavailable
$34.10 lower than Merced for the office setting.
South Dakota**
South Dakota · 78740
Office
$219.45
Facility
Unavailable
$19.92 lower than Merced for the office setting.
Tennessee
Tennessee · 78740
Office
$201.65
Facility
Unavailable
$37.72 lower than Merced for the office setting.
Austin
Texas · 78740
Office
$232.19
Facility
Unavailable
$7.18 lower than Merced for the office setting.
Beaumont
Texas · 78740
Office
$202.63
Facility
Unavailable
$36.74 lower than Merced for the office setting.
Brazoria
Texas · 78740
Office
$218.69
Facility
Unavailable
$20.68 lower than Merced for the office setting.
Dallas
Texas · 78740
Office
$219.86
Facility
Unavailable
$19.51 lower than Merced for the office setting.
Fort Worth
Texas · 78740
Office
$217.89
Facility
Unavailable
$21.48 lower than Merced for the office setting.
Galveston
Texas · 78740
Office
$219.18
Facility
Unavailable
$20.19 lower than Merced for the office setting.
Houston
Texas · 78740
Office
$220.28
Facility
Unavailable
$19.09 lower than Merced for the office setting.
Rest Of Texas
Texas · 78740
Office
$210.38
Facility
Unavailable
$28.99 lower than Merced for the office setting.
Utah
Utah · 78740
Office
$208.57
Facility
Unavailable
$30.80 lower than Merced for the office setting.
Virginia
Virginia · 78740
Office
$216.79
Facility
Unavailable
$22.58 lower than Merced for the office setting.
Virgin Islands
United States Virgin Islands · 78740
Office
$222.95
Facility
Unavailable
$16.42 lower than Merced for the office setting.
Vermont
Vermont · 78740
Office
$217.79
Facility
Unavailable
$21.58 lower than Merced for the office setting.
Rest Of Washington
Washington · 78740
Office
$231.15
Facility
Unavailable
$8.22 lower than Merced for the office setting.
Seattle (King Cnty)
Washington · 78740
Office
$266.76
Facility
Unavailable
$27.39 higher than Merced for the office setting.
Wisconsin
Wisconsin · 78740
Office
$210.99
Facility
Unavailable
$28.38 lower than Merced for the office setting.
West Virginia
West Virginia · 78740
Office
$195.43
Facility
Unavailable
$43.94 lower than Merced for the office setting.
Wyoming**
Wyoming · 78740
Office
$220.26
Facility
Unavailable
$19.11 lower than Merced for the office setting.
See how rates vary across the country
78740 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$191.60
$274.86
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $242.24 | 1 |
| AL | $194.90 | 1 |
| AR | $191.60 | 1 |
| AZ | $214.29 | 1 |
| CA | $239.37–$310.34 | 29 |
| CO | $233.37 | 1 |
| CT | $236.98 | 1 |
| DC | $257.63 | 1 |
| DE | $218.27 | 1 |
| FL | $212.98–$232.05 | 3 |
| GA | $199.56–$224.44 | 2 |
| GU | $247.35 | 1 |
| HI | $247.35 | 1 |
| IA | $202.57 | 1 |
| ID | $203.72 | 1 |
| IL | $204.50–$227.86 | 4 |
| IN | $205.14 | 1 |
| KS | $200.58 | 1 |
| KY | $198.40 | 1 |
| LA | $197.69–$209.25 | 2 |
| MA | $231.28–$260.14 | 2 |
| MD | $223.20–$257.63 | 3 |
| ME | $204.02–$218.24 | 2 |
| MI | $203.63–$215.15 | 2 |
| MN | $225.17 | 1 |
| MO | $193.12–$211.18 | 3 |
| MS | $192.45 | 1 |
| MT | $220.78 | 1 |
| NC | $206.65 | 1 |
| ND | $219.59 | 1 |
| NE | $204.13 | 1 |
| NH | $228.73 | 1 |
| NJ | $240.13–$254.11 | 2 |
| NM | $204.58 | 1 |
| NV | $220.65 | 1 |
| NY | $210.18–$261.51 | 5 |
| OH | $203.39 | 1 |
| OK | $198.93 | 1 |
| OR | $219.38–$242.77 | 2 |
| PA | $204.26–$229.71 | 2 |
| PR | $222.95 | 1 |
| RI | $227.52 | 1 |
| SC | $205.27 | 1 |
| SD | $219.45 | 1 |
| TN | $201.65 | 1 |
| TX | $202.63–$232.19 | 8 |
| UT | $208.57 | 1 |
| VA | $216.79–$257.63 | 2 |
| VI | $222.95 | 1 |
| VT | $217.79 | 1 |
| WA | $231.15–$266.76 | 2 |
| WI | $210.99 | 1 |
| WV | $195.43 | 1 |
| WY | $220.26 | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 78740 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$263.31
$239.37 × 110% = $263.31
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.
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 78740 in Merced.
PPRRVU2026_Oct_nonQPP.csv
9,503
- Code
- 78740
- Physician work
- 0.56
- Practice expense
- 5.99
- Malpractice
- 0.06
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.56 | × 1.017 | 0.5695 |
| Practice expense | 5.99 | × 1.096 | 6.5650 |
| Malpractice | 0.06 | × 0.536 | 0.0322 |
| Total RVUs | 7.1667 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Merced$239.37
Open 78740 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.56 | 1.017 |
| Practice expense | 5.99 | 1.096 |
| Malpractice | 0.06 | 0.536 |
(0.56 × 1.017 + 5.99 × 1.096 + 0.06 × 0.536) × $33.4009 = $239.37
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
78740 · Office / nonfacility
$239.37
Effective 2026-10-01
The base rate is $20.19 higher than on 2025-10-01, moving from $219.18 to $239.37 (9.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$219.18changed to$239.37
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.57 changed to 0.56
- Practice expense RVU 5.64 changed to 5.99
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $219.18
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $239.37 | Not available in this setting | RVU26D |
| 2026-07-01 | $239.37 | Not available in this setting | RVU26C |
| 2026-04-01 | $239.37 | Not available in this setting | RVU26B |
| 2026-01-01 | $239.37 | Not available in this setting | RVU26A |
| 2025-10-01 | $219.18 | Not available in this setting | RVU25D |
| 2025-07-01 | $219.18 | Not available in this setting | RVU25C |
| 2025-04-01 | $219.18 | Not available in this setting | RVU25B |
| 2025-01-01 | $219.18 | Not available in this setting | RVU25A |
78740 billing questions
How does this differ from a fluoroscopic voiding cystourethrogram?
This code is for radionuclide imaging of reflux. CPT 74455 describes the fluoroscopic voiding cystourethrography approach.
When should modifier 26 or TC be used?
Use modifier 26 for the physician's interpretation and modifier TC for the technical service. Submit without either modifier when billing the global service.
What documentation supports this study?
Document the clinical concern for ureteral reflux and the radionuclide imaging performed to evaluate it. The report should support the physician's interpretation when billing modifier 26.
Is this the right code for a renal drainage study?
No. A study focused on renal flow or drainage, such as CPT 78708, is distinct from imaging for reflux from the bladder into the ureters.
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.
