Billing code 78201: Liver imagingMedicare rate & RVUs in Illinois
Reports radionuclide imaging focused on static liver images when the examination does not include vascular-flow imaging or spleen imaging.
Medicare pays $159.30–$177.52 for 78201 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 78201 covers
78201 represents a radionuclide study that produces static images focused on the liver, without vascular-flow imaging. Nuclear medicine staff acquire the images, and a nuclear medicine physician interprets findings such as hepatic distribution, contour, or focal abnormalities. The study may be performed in a hospital imaging department or outpatient nuclear medicine facility when the clinical question calls for static liver scintigraphy rather than evaluation of biliary transit.
Select the code from the documented protocol and images: report 78201 for static liver imaging alone, 78202 when vascular-flow imaging is included, and 78215 or 78216 when the study also images the spleen. The order, imaging record, and interpretation should support the liver-only static examination. CMS recognizes separately priced professional and technical components: use modifier 26 for the interpretation and modifier TC for the equipment and staff; billing without either modifier represents the global service.
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.
Where 78201 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$159.30 to $177.52
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $175.15 | Unavailable |
| East St. Louis | $161.29 | Unavailable |
| Rest Of Illinois | $159.30 | Unavailable |
| Suburban Chicago | $177.52 | Unavailable |
How the 78201 rate is calculated
Each of 78201’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 78201
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.43Practice expense 4.65Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78201
The CMS indicators that decide how 78201 is paid alongside other services.
CMS payment indicators · 78201
Liver imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
78201 without 26 · national office
$171.68
Liver imaging
78201-26 · Professional component
$19.71
Pays only the interpretation and report.
78201 compared with similar codes
Compare codes
78201 vs 78202 vs 78215 vs 78216 vs 78226: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78202Liver imaging
- Choose 78201 for static liver images alone; choose 78202 when vascular-flow imaging is part of the examination.
- 78215Liver-spleen scan
- 78215 covers static imaging of both the liver and spleen, while 78201 is limited to liver imaging.
- 78216Liver-spleen scan
- 78216 includes liver and spleen imaging with vascular-flow imaging; 78201 is static liver imaging alone.
- 78226Hepatobiliary imaging
- 78226 is for hepatobiliary system imaging, addressing biliary function or transit rather than static liver imaging alone.
78201 billing questions
How does 78201 differ from 78202?
78201 identifies static liver imaging alone. Use 78202 when the examination includes vascular-flow imaging.
When is 78215 a better fit?
Use 78215 for static imaging of both the liver and spleen. Code 78201 is focused on the liver alone.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 78201?
The order, imaging record, and interpretation should establish that the service was static imaging of the liver alone, without vascular-flow imaging or spleen imaging.
Is 78201 the code for a hepatobiliary study?
No. 78201 describes static liver imaging; 78226 is used for imaging of the hepatobiliary system.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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