$251.37
Both cover hepatobiliary imaging; 78227 includes a pharmacologic intervention, while 78226 describes imaging without one.
On this page
CMS RVU26D · Effective 2026-10-01
78227 Hepatobiliary scan Medicare reimbursement rates in Alabama
Reports hepatobiliary nuclear imaging with a medication intervention, such as stimulation of gallbladder emptying, when the clinical question requires a drug-assisted study. Compare 78227 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 78227 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$337.36
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nuclear medicine
About 78227: Hepatobiliary scan with drug intervention
Reports hepatobiliary nuclear imaging with a medication intervention, such as stimulation of gallbladder emptying, when the clinical question requires a drug-assisted study.
A nuclear medicine team administers a hepatobiliary radiotracer and obtains images of tracer movement through the liver and biliary system, including the gallbladder when present. A medication may be used to stimulate gallbladder contraction for an emptying assessment or to alter biliary transit. Studies may help evaluate suspected gallbladder dysfunction or selected biliary disorders. A nuclear medicine physician interprets the images; technologists typically perform the acquisition in a hospital or imaging center.
Choose this code when the study includes pharmacologic intervention, rather than imaging without that intervention. The report should identify the medication and its purpose, describe the imaging and any quantitative measurements, and document the clinical question and interpretation. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional service, modifier TC for the technical service, or neither modifier when billing the global service. The study’s medication intervention is part of the described imaging service; radiopharmaceutical supply may be represented by a separate applicable code.
CMS billing rules for 78227
- 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 RVU0.88 · 8%
- Practice expense (office) RVU10.46 · 91%
- Malpractice RVU0.12 · 1%
42.2K
Medicare services in 2024 · #848 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.
78227 compared with similar codes
Office rates for Alabama, from the same CMS release.
$151.40
78201 is static liver imaging. Choose 78227 for a drug-assisted study focused on hepatobiliary tracer transit or gallbladder function.
$157.35
78215 images the liver and spleen. It is not the drug-assisted hepatobiliary study represented by 78227.
Compare 78227 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$337.36
Facility
Unavailable
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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 78227 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
9,272
- Code
- 78227
- Physician work
- 0.88
- Practice expense
- 10.46
- Malpractice
- 0.12
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.88 | × 1.000 | 0.8800 |
| Practice expense | 10.46 | × 0.875 | 9.1525 |
| Malpractice | 0.12 | × 0.566 | 0.0679 |
| Total RVUs | 10.1004 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$337.36
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.88 | 1 |
| Practice expense | 10.46 | 0.875 |
| Malpractice | 0.12 | 0.566 |
(0.88 × 1 + 10.46 × 0.875 + 0.12 × 0.566) × $33.4009 = $337.36
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.
78227 billing questions
How does this differ from 78226?
Use 78227 when the hepatobiliary imaging includes a pharmacologic intervention. Use 78226 for hepatobiliary imaging without that intervention.
Can the interpretation and imaging be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
What should the report document?
Document the medication used and why, the imaging performed, any quantitative measurements, and the physician’s findings and interpretation.
Is this reported once per image or view?
Report the imaging study, not each image or view. The medication-assisted assessment and any quantitative measurements belong to the study.
Can the radiopharmaceutical supply be reported separately?
A hepatobiliary radiopharmaceutical supply code may be relevant, such as A9537 or A9512. The applicable supply billing depends on the setting and the claim circumstances.
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.
9,26978226,,Hepatobiliary system imaging,A,,0.72,7.72,,7.72,NA,0.09,8.53,8.53,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.40,12.40,0.12
9,27078226,26,Hepatobiliary system imaging,A,,0.72,0.25,,0.25,,0.04,1.01,1.01,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,27178226,TC,Hepatobiliary system imaging,A,,0.00,7.47,,7.47,NA,0.05,7.52,7.52,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.15,12.15,0.08
9,27278227,,Hepatobil syst image w/drug,A,,0.88,10.46,,10.46,NA,0.12,11.46,11.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.79,16.79,0.16
9,27378227,26,Hepatobil syst image w/drug,A,,0.88,0.30,,0.30,,0.05,1.23,1.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,27478227,TC,Hepatobil syst image w/drug,A,,0.00,10.16,,10.16,NA,0.07,10.23,10.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.49,16.49,0.11
9,27578230,,Salivary gland imaging,A,,0.44,4.22,,4.22,NA,0.07,4.73,4.73,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.27,12.27,0.15
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515