Billing code 78202: Liver imagingMedicare rate & RVUs in Illinois
Reports radionuclide liver imaging that includes vascular-flow acquisition, used when the diagnostic study evaluates hepatic perfusion along with liver distribution.
Medicare pays $178.32–$198.65 for 78202 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 78202 covers
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.
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 78202 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
$178.32 to $198.65
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $196.06 | Unavailable |
| East St. Louis | $180.58 | Unavailable |
| Rest Of Illinois | $178.32 | Unavailable |
| Suburban Chicago | $198.65 | Unavailable |
How the 78202 rate is calculated
Each of 78202’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 · 78202
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.50Practice expense 5.18Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78202
The CMS indicators that decide how 78202 is paid alongside other services.
CMS payment indicators · 78202
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
78202 without 26 · national office
$192.06
Liver imaging
78202-26 · Professional component
$23.05
Pays only the interpretation and report.
78202 compared with similar codes
Compare codes
78202 vs 78201 vs 78216 vs 78226: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78201Liver imaging
- Choose 78202 when vascular-flow imaging is performed with the liver study; 78201 describes liver imaging without that phase.
- 78216Liver-spleen scan
- 78216 covers imaging of both the liver and spleen with vascular flow. Use 78202 for a liver-only study with flow.
- 78226Hepatobiliary imaging
- 78226 is hepatobiliary system imaging, not liver imaging with a vascular-flow phase; select according to the imaging study performed.
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 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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