$176.31
Use 78231 when the study includes serial images. 78230 represents salivary gland imaging without the serial-image distinction.
On this page
CMS RVU26D · Effective 2026-10-01
78231 Salivary imaging Medicare reimbursement rates in Hawaii
Serial salivary gland scintigraphy records tracer distribution over time to evaluate the glands when a clinician orders sequential imaging. Compare 78231 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 78231 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
$115.98
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 78231: Serial salivary gland scintigraphy
Serial salivary gland scintigraphy records tracer distribution over time to evaluate the glands when a clinician orders sequential imaging.
This nuclear medicine study obtains sequential images of the salivary glands after administration of a radioactive tracer. The images show how tracer reaches and moves through the glands over time. A nuclear medicine technologist typically performs the acquisition in a hospital imaging department or outpatient nuclear medicine center; a physician, often a radiologist or nuclear medicine physician, interprets the study. The ordering clinician may use it when evaluating suspected salivary gland dysfunction or an abnormality affecting tracer uptake or passage.
Report 78231 when the performed service includes serial salivary gland images, rather than a nonserial imaging service or a separately defined function study. The record should identify the clinical indication, tracer administration, imaging sequence, and the physician’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither modifier when billing the global service. CMS separately prices the 26 and TC components.
CMS billing rules for 78231
- 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 RVU0.51 · 16%
- Practice expense (office) RVU2.58 · 82%
- Malpractice RVU0.05 · 2%
84
Medicare services in 2024 · #5009 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.
78231 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$114.31
78232 describes a salivary gland function study; 78231 describes serial imaging. Follow the service performed and documented.
$318.97
78226 is hepatobiliary system imaging, not salivary gland imaging. The anatomy and diagnostic study determine which code applies.
Compare 78231 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
$115.98
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 78231 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
9,278
- Code
- 78231
- Physician work
- 0.51
- Practice expense
- 2.58
- Malpractice
- 0.05
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.51 | × 1.000 | 0.5100 |
| Practice expense | 2.58 | × 1.137 | 2.9335 |
| Malpractice | 0.05 | × 0.579 | 0.0290 |
| Total RVUs | 3.4724 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$115.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.51 | 1 |
| Practice expense | 2.58 | 1.137 |
| Malpractice | 0.05 | 0.579 |
(0.51 × 1 + 2.58 × 1.137 + 0.05 × 0.579) × $33.4009 = $115.98
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.
78231 billing questions
How does 78231 differ from 78230?
78231 is for serial images acquired over time. 78230 describes salivary gland imaging without that serial-image distinction.
When should 78232 be used instead?
Use 78232 when the performed service is a salivary gland function study. Select 78231 when the service is serial imaging, as documented in the imaging protocol.
Which modifier reports only the interpretation?
Append modifier 26 for the physician’s professional interpretation. Modifier TC identifies the technical portion, while billing without either modifier represents the global service.
What documentation supports 78231?
Document the clinical indication, tracer administration, serial image acquisition, and interpretation. The record should make clear that sequential images were obtained.
Can 78230 and 78231 be reported together?
Choose the code that matches the salivary imaging service actually performed. The documentation should support the serial-image service for 78231 rather than treating the two codes as interchangeable.
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.
9,27578230,,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
9,27678230,26,Salivary gland imaging,A,,0.44,0.16,,0.16,,0.03,0.63,0.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,27778230,TC,Salivary gland imaging,A,,0.00,4.06,,4.06,NA,0.04,4.10,4.10,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.11,12.11,0.12
9,27878231,,Salivary glnd img serial img,A,,0.51,2.58,,2.58,NA,0.05,3.14,3.14,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.12,12.12,0.20
9,27978231,26,Salivary glnd img serial img,A,,0.51,0.09,,0.09,,0.01,0.61,0.61,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,28078231,TC,Salivary glnd img serial img,A,,0.00,2.49,,2.49,NA,0.04,2.53,2.53,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.03,12.03,0.19
9,28178232,,Salivary gland function std,A,,0.46,2.58,,2.58,NA,0.05,3.09,3.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.11,12.11,0.20
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