Billing code 78725: Kidney function studyMedicare rate & RVUs in Illinois
Reports a quantitative kidney-function study, such as renal clearance measurement, when the clinical question requires a measured functional result.
Medicare pays $93.25–$103.47 for 78725 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 78725 covers
This service quantifies kidney function, commonly by measuring renal clearance rather than primarily depicting kidney anatomy or perfusion. A protocol may involve tracer administration and timed blood or urine measurements; the clearance calculation provides a functional result such as filtration. Nuclear medicine or radiology teams perform and interpret the study when the clinical question calls for a quantitative renal-function result rather than a visual renal scan.
Report 78725 when the documented procedure is a quantitative kidney-function or clearance study. The record should identify the indication, method, measurements, and physician interpretation of the calculated result. CMS recognizes professional and technical portions: report modifier 26 for the physician’s interpretation, modifier TC for equipment and staff, or no component modifier for the global service. The interpretation should support the professional portion, and the technical record should support performance of the protocol and measurements.
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 78725 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
$93.25 to $103.47
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $102.64 | Unavailable |
| East St. Louis | $94.75 | Unavailable |
| Rest Of Illinois | $93.25 | Unavailable |
| Suburban Chicago | $103.47 | Unavailable |
How the 78725 rate is calculated
Each of 78725’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 · 78725
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.37Practice expense 2.55Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78725
The CMS indicators that decide how 78725 is paid alongside other services.
CMS payment indicators · 78725
Kidney function study
| 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
78725 without 26 · national office
$99.53
Kidney function study
78725-26 · Professional component
$17.03
Pays only the interpretation and report.
78725 compared with similar codes
Compare codes
78725 vs 78707 vs 78708 vs 78700: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78707Renal imaging
- Use 78707 for renal flow and function imaging without pharmacologic intervention. Use 78725 when the service quantifies kidney function through a clearance study.
- 78708Renal imaging
- 78708 describes renal flow and function imaging with pharmacologic intervention; 78725 describes quantitative kidney-function or clearance measurement.
- 78700Kidney imaging
- 78700 is for imaging kidney morphology. Choose 78725 for a quantitative functional measurement such as renal clearance.
78725 billing questions
How is 78725 different from renal flow and function imaging?
78725 is for a quantitative kidney-function or clearance study. Codes 78707–78709 describe renal flow and function imaging, with the applicable code depending on the study performed.
When should modifier 26 or TC be used?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical service, including equipment and staff. Submit the global service without either component modifier when billing both portions together.
What documentation supports 78725?
Document the clinical indication, clearance method and measurements, and the resulting physician interpretation. The technical record should show that the study protocol and measurements were performed.
Can 78725 be reported with renal imaging on the same date?
Choose the code for the service actually performed: quantitative clearance for 78725, or the applicable renal imaging code for an imaging study. Documentation should establish the services performed rather than relying only on the shared renal-function indication.
Does 78725 describe an anatomic kidney scan?
No. It describes quantitative assessment of kidney function, such as renal clearance; codes 78700 and 78701 describe renal imaging services.
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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