$192.11
Choose 78202 when vascular-flow imaging is performed with the liver study; 78201 describes liver imaging without that phase.
On this page
CMS RVU26D · Effective 2026-10-01
78202 Liver imaging Medicare reimbursement rates in Hawaii
Reports radionuclide liver imaging that includes vascular-flow acquisition, used when the diagnostic study evaluates hepatic perfusion along with liver distribution. Compare 78202 office and facility rates across CMS payment localities in Hawaii.
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 78202 in Hawaii?
Hawaii 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
$214.77
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 78202: Liver imaging with vascular flow
Reports radionuclide liver imaging that includes vascular-flow acquisition, used when the diagnostic study evaluates hepatic perfusion along with liver distribution.
This nuclear medicine study images the liver and includes acquisition of a vascular-flow phase. A nuclear medicine technologist performs the imaging in a hospital or other diagnostic imaging department, and a qualified practitioner interprets the study. The flow images add information about hepatic perfusion to the images showing distribution in the liver; the order and report should identify the clinical question and the imaging performed.
Select this code when the study covers the liver and includes vascular-flow imaging. Use the static-only liver code when flow imaging is not performed, and distinguish liver-only imaging from studies that also include the spleen. The record should support the liver study, the flow acquisition, and the interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Both modifiers are separately priced.
CMS billing rules for 78202
- 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 RVU0.50 · 9%
- Practice expense (office) RVU5.18 · 90%
- Malpractice RVU0.07 · 1%
115
Medicare services in 2024 · #4776 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.
78202 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$146.14
78216 covers imaging of both the liver and spleen with vascular flow. Use 78202 for a liver-only study with flow.
$318.97
78226 is hepatobiliary system imaging, not liver imaging with a vascular-flow phase; select according to the imaging study performed.
Compare 78202 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
Hawaii, Guam →
Office / nonfacility
$214.77
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 78202 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
9,260
- Code
- 78202
- Physician work
- 0.50
- Practice expense
- 5.18
- Malpractice
- 0.07
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 5.18 | × 1.137 | 5.8897 |
| Malpractice | 0.07 | × 0.579 | 0.0405 |
| Total RVUs | 6.4302 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$214.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.5 | 1 |
| Practice expense | 5.18 | 1.137 |
| Malpractice | 0.07 | 0.579 |
(0.5 × 1 + 5.18 × 1.137 + 0.07 × 0.579) × $33.4009 = $214.77
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.
78202 billing questions
How does this differ from 78201?
78202 includes a vascular-flow phase with liver imaging. 78201 is for liver imaging without that flow phase.
When should 78216 be used instead?
78216 includes both liver and spleen imaging with vascular flow. Use 78202 when the performed study images the liver only.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.
What should the report document?
Document the liver imaging and vascular-flow acquisition, the clinical indication, and the interpreting practitioner's findings. The record should make clear whether the spleen was also imaged.
Is each image or flow acquisition billed as a separate unit?
The code represents the liver imaging study with vascular flow, not each individual image. Report the study performed rather than counting its image frames as separate services.
Is this the same as hepatobiliary imaging?
No. 78202 evaluates liver distribution with vascular-flow imaging; 78226 concerns hepatobiliary system imaging and addresses a different imaging question.
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.
9,25778201,,Liver imaging static only,A,,0.43,4.65,,4.65,NA,0.06,5.14,5.14,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.60,16.60,0.17
9,25878201,26,Liver imaging static only,A,,0.43,0.14,,0.14,,0.02,0.59,0.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,25978201,TC,Liver imaging static only,A,,0.00,4.51,,4.51,NA,0.04,4.55,4.55,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.46,16.46,0.15
9,26078202,,Liver imaging with vasc flow,A,,0.50,5.18,,5.18,NA,0.07,5.75,5.75,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.64,16.64,0.16
9,26178202,26,Liver imaging with vasc flow,A,,0.50,0.16,,0.16,,0.03,0.69,0.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,26278202,TC,Liver imaging with vasc flow,A,,0.00,5.02,,5.02,NA,0.04,5.06,5.06,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.48,16.48,0.13
9,26378215,,Lvr&spleen img static only,A,,0.48,4.79,,4.79,NA,0.07,5.34,5.34,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.29,12.29,0.14
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014