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CMS RVU26D · Effective 2026-10-01

78835 in Modesto

Office / nonfacility

$96.70

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 78835: Radiopharmaceutical quantification, single area

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

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.

CMS billing rules for 78835

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
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 RVU0.46 · 17%
  • Practice expense (office) RVU2.20 · 82%
  • Malpractice RVU0.03 · 1%

4.7K

Medicare services in 2024 · #1920 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.

78835 compared with similar codes

Office rates for Modesto, from the same CMS release.

78800

Tumor imaging

Single area, one day

$250.55

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.

78803

Tumor SPECT

Single body area

$363.24

78803 reports SPECT tumor localization, while 78835 reports quantitative measurement of activity in an area alongside an eligible localization study.

78830

Tumor SPECT/CT

Single imaging area

$455.18

78830 reports SPECT/CT tumor localization in one area. It describes the primary imaging service, not the additional quantification captured by 78835.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 78835 is $96.80—$0.10 higher than the $96.70 rate in Modesto. Both use the same code, release and participation basis.

78835 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $96.70

  2. Bakersfield

    $96.80

    $0.10 higher than Modesto

  3. Chico

    $96.70

    The same base rate than Modesto

  4. El Centro

    $96.70

    The same base rate than Modesto

  5. Fresno

    $96.70

    The same base rate than Modesto

  6. Hanford-Corcoran

    $96.70

    The same base rate than Modesto

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

    $103.59

    $6.89 higher than Modesto

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, 78835 ranges from $79.00 in Arkansas to $123.55 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 · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Merced

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Napa

    California · 78835

    Office

    $113.69

    Facility

    Unavailable

    $16.99 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 78835

    Office

    $103.27

    Facility

    Unavailable

    $6.57 higher than Modesto for the office setting.

  • Redding

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 78835

    Office

    $97.03

    Facility

    Unavailable

    $0.33 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 78835

    Office

    $101.91

    Facility

    Unavailable

    $5.21 higher than Modesto for the office setting.

  • Salinas

    California · 78835

    Office

    $101.54

    Facility

    Unavailable

    $4.84 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 78835

    Office

    $104.25

    Facility

    Unavailable

    $7.55 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 78835

    Office

    $120.89

    Facility

    Unavailable

    $24.19 higher than Modesto for the office setting.

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

    California · 78835

    Office

    $120.86

    Facility

    Unavailable

    $24.16 higher than Modesto for the office setting.

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

    California · 78835

    Office

    $123.55

    Facility

    Unavailable

    $26.85 higher than Modesto for the office setting.

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

    California · 78835

    Office

    $123.41

    Facility

    Unavailable

    $26.71 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 78835

    Office

    $99.86

    Facility

    Unavailable

    $3.16 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 78835

    Office

    $105.50

    Facility

    Unavailable

    $8.80 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 78835

    Office

    $102.01

    Facility

    Unavailable

    $5.31 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 78835

    Office

    $106.60

    Facility

    Unavailable

    $9.90 higher than Modesto for the office setting.

  • Stockton

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 78835

    Office

    $113.64

    Facility

    Unavailable

    $16.94 higher than Modesto for the office setting.

  • Visalia

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 78835

    Office

    $96.70

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 78835

    Office

    $103.87

    Facility

    Unavailable

    $7.17 higher than Modesto for the office setting.

  • Miami

    Florida · 78835

    Office

    $94.39

    Facility

    Unavailable

    $2.31 lower than Modesto for the office setting.

  • Chicago

    Illinois · 78835

    Office

    $91.62

    Facility

    Unavailable

    $5.08 lower than Modesto for the office setting.

  • Manhattan

    New York · 78835

    Office

    $103.32

    Facility

    Unavailable

    $6.62 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 78835

    Office

    $101.86

    Facility

    Unavailable

    $5.16 higher than Modesto for the office setting.

  • Alabama

    Alabama · 78835

    Office

    $80.23

    Facility

    Unavailable

    $16.47 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 78835

    Office

    $79.00

    Facility

    Unavailable

    $17.70 lower than Modesto for the office setting.

  • Arizona

    Arizona · 78835

    Office

    $87.43

    Facility

    Unavailable

    $9.27 lower than Modesto for the office setting.

  • Colorado

    Colorado · 78835

    Office

    $94.52

    Facility

    Unavailable

    $2.18 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 78835

    Office

    $96.02

    Facility

    Unavailable

    $0.68 lower than Modesto for the office setting.

  • Delaware

    Delaware · 78835

    Office

    $88.94

    Facility

    Unavailable

    $7.76 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 78835

    Office

    $91.61

    Facility

    Unavailable

    $5.09 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 78835

    Office

    $87.12

    Facility

    Unavailable

    $9.58 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 78835

    Office

    $91.27

    Facility

    Unavailable

    $5.43 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 78835

    Office

    $82.10

    Facility

    Unavailable

    $14.60 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 78835

    Office

    $99.49

    Facility

    Unavailable

    $2.79 higher than Modesto for the office setting.

  • Iowa

    Iowa · 78835

    Office

    $83.00

    Facility

    Unavailable

    $13.70 lower than Modesto for the office setting.

  • Idaho

    Idaho · 78835

    Office

    $83.44

    Facility

    Unavailable

    $13.26 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 78835

    Office

    $84.99

    Facility

    Unavailable

    $11.71 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 78835

    Office

    $84.02

    Facility

    Unavailable

    $12.68 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 78835

    Office

    $92.71

    Facility

    Unavailable

    $3.99 lower than Modesto for the office setting.

  • Indiana

    Indiana · 78835

    Office

    $83.97

    Facility

    Unavailable

    $12.73 lower than Modesto for the office setting.

  • Kansas

    Kansas · 78835

    Office

    $82.30

    Facility

    Unavailable

    $14.40 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 78835

    Office

    $81.61

    Facility

    Unavailable

    $15.09 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 78835

    Office

    $85.65

    Facility

    Unavailable

    $11.05 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 78835

    Office

    $81.36

    Facility

    Unavailable

    $15.34 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 78835

    Office

    $104.62

    Facility

    Unavailable

    $7.92 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 78835

    Office

    $93.79

    Facility

    Unavailable

    $2.91 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 78835

    Office

    $95.70

    Facility

    Unavailable

    $1.00 lower than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 78835

    Office

    $90.80

    Facility

    Unavailable

    $5.90 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 78835

    Office

    $83.59

    Facility

    Unavailable

    $13.11 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 78835

    Office

    $88.82

    Facility

    Unavailable

    $7.88 lower than Modesto for the office setting.

  • Detroit

    Michigan · 78835

    Office

    $87.96

    Facility

    Unavailable

    $8.74 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 78835

    Office

    $83.58

    Facility

    Unavailable

    $13.12 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 78835

    Office

    $91.27

    Facility

    Unavailable

    $5.43 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 78835

    Office

    $85.34

    Facility

    Unavailable

    $11.36 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 78835

    Office

    $86.32

    Facility

    Unavailable

    $10.38 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 78835

    Office

    $79.68

    Facility

    Unavailable

    $17.02 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 78835

    Office

    $79.37

    Facility

    Unavailable

    $17.33 lower than Modesto for the office setting.

  • Montana**

    Montana · 78835

    Office

    $89.85

    Facility

    Unavailable

    $6.85 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 78835

    Office

    $84.56

    Facility

    Unavailable

    $12.14 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 78835

    Office

    $89.25

    Facility

    Unavailable

    $7.45 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 78835

    Office

    $83.57

    Facility

    Unavailable

    $13.13 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 78835

    Office

    $92.74

    Facility

    Unavailable

    $3.96 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 78835

    Office

    $102.64

    Facility

    Unavailable

    $5.94 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 78835

    Office

    $97.32

    Facility

    Unavailable

    $0.62 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 78835

    Office

    $83.95

    Facility

    Unavailable

    $12.75 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 78835

    Office

    $89.75

    Facility

    Unavailable

    $6.95 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 78835

    Office

    $105.58

    Facility

    Unavailable

    $8.88 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 78835

    Office

    $97.73

    Facility

    Unavailable

    $1.03 higher than Modesto for the office setting.

  • Queens

    New York · 78835

    Office

    $104.65

    Facility

    Unavailable

    $7.95 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 78835

    Office

    $85.88

    Facility

    Unavailable

    $10.82 lower than Modesto for the office setting.

  • Ohio

    Ohio · 78835

    Office

    $83.46

    Facility

    Unavailable

    $13.24 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 78835

    Office

    $81.76

    Facility

    Unavailable

    $14.94 lower than Modesto for the office setting.

  • Portland

    Oregon · 78835

    Office

    $97.99

    Facility

    Unavailable

    $1.29 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 78835

    Office

    $89.26

    Facility

    Unavailable

    $7.44 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 78835

    Office

    $93.33

    Facility

    Unavailable

    $3.37 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 78835

    Office

    $83.77

    Facility

    Unavailable

    $12.93 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 78835

    Office

    $90.64

    Facility

    Unavailable

    $6.06 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 78835

    Office

    $92.46

    Facility

    Unavailable

    $4.24 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 78835

    Office

    $84.11

    Facility

    Unavailable

    $12.59 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 78835

    Office

    $89.18

    Facility

    Unavailable

    $7.52 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 78835

    Office

    $82.70

    Facility

    Unavailable

    $14.00 lower than Modesto for the office setting.

  • Austin

    Texas · 78835

    Office

    $94.03

    Facility

    Unavailable

    $2.67 lower than Modesto for the office setting.

  • Beaumont

    Texas · 78835

    Office

    $83.16

    Facility

    Unavailable

    $13.54 lower than Modesto for the office setting.

  • Brazoria

    Texas · 78835

    Office

    $89.09

    Facility

    Unavailable

    $7.61 lower than Modesto for the office setting.

  • Dallas

    Texas · 78835

    Office

    $89.55

    Facility

    Unavailable

    $7.15 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 78835

    Office

    $88.83

    Facility

    Unavailable

    $7.87 lower than Modesto for the office setting.

  • Galveston

    Texas · 78835

    Office

    $89.28

    Facility

    Unavailable

    $7.42 lower than Modesto for the office setting.

  • Houston

    Texas · 78835

    Office

    $89.83

    Facility

    Unavailable

    $6.87 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 78835

    Office

    $86.00

    Facility

    Unavailable

    $10.70 lower than Modesto for the office setting.

  • Utah

    Utah · 78835

    Office

    $85.34

    Facility

    Unavailable

    $11.36 lower than Modesto for the office setting.

  • Virginia

    Virginia · 78835

    Office

    $88.30

    Facility

    Unavailable

    $8.40 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 78835

    Office

    $90.64

    Facility

    Unavailable

    $6.06 lower than Modesto for the office setting.

  • Vermont

    Vermont · 78835

    Office

    $88.62

    Facility

    Unavailable

    $8.08 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 78835

    Office

    $93.70

    Facility

    Unavailable

    $3.00 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 78835

    Office

    $107.11

    Facility

    Unavailable

    $10.41 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 78835

    Office

    $86.07

    Facility

    Unavailable

    $10.63 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 78835

    Office

    $80.65

    Facility

    Unavailable

    $16.05 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 78835

    Office

    $89.59

    Facility

    Unavailable

    $7.11 lower than Modesto for the office setting.

See how rates vary across the country

78835 · 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.

$79.00

$110.13

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

View all state and territory rates as a table
State / territoryRate 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

Explore 78835 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 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 78835 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$106.37

$96.70 × 110% = $106.37

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 78835 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

9,555

Code
78835
Physician work
0.46
Practice expense
2.20
Malpractice
0.03

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 78835 in Modesto
ComponentRVULocality factorAdjusted
Physician work0.46× 1.0170.4678
Practice expense2.20× 1.0962.4112
Malpractice0.03× 0.5360.0161
Total RVUs2.8951
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$96.70

Open 78835 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.461.017
Practice expense2.21.096
Malpractice0.030.536

(0.46 × 1.017 + 2.2 × 1.096 + 0.03 × 0.536) × $33.4009 = $96.70

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

78835 · Office / nonfacility

$96.70

Effective 2026-10-01

The base rate is $4.73 higher than on 2025-10-01, moving from $91.97 to $96.70 (5.1%).

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

    $91.97changed to$96.70

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.47 changed to 0.46
    • Practice expense RVU 2.15 changed to 2.20
    • 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.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $91.97

    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$96.70Not available in this settingRVU26D
2026-07-01$96.70Not available in this settingRVU26C
2026-04-01$96.70Not available in this settingRVU26B
2026-01-01$96.70Not available in this settingRVU26A
2025-10-01$91.97Not available in this settingRVU25D
2025-07-01$91.97Not available in this settingRVU25C
2025-04-01$91.97Not available in this settingRVU25B
2025-01-01$91.97Not available in this settingRVU25A

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 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 78835PPRRVU2026_Oct_nonQPP.csv, line 9,555 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet