$266.51
78290 is for intestine imaging. Choose 78291 when the diagnostic target is flow through an existing peritoneovenous shunt.
On this page
CMS RVU26D · Effective 2026-10-01
78291 Shunt imaging Medicare reimbursement rates in Iowa
Nuclear medicine imaging tracks peritoneal tracer passage through an existing peritoneovenous shunt when impaired flow or shunt patency is in question. Compare 78291 office and facility rates across CMS payment localities in Iowa.
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 78291 in Iowa?
Iowa 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
$213.90
1 of 1 localities have a supported rate.
Payment area: Iowa
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 78291: Peritoneovenous shunt patency study
Nuclear medicine imaging tracks peritoneal tracer passage through an existing peritoneovenous shunt when impaired flow or shunt patency is in question.
This nuclear medicine study evaluates whether an existing peritoneovenous shunt is open and conveying peritoneal fluid into the venous circulation. A radiotracer is introduced into the peritoneal cavity, and imaging tracks its passage through the shunt. The study may be ordered for a patient with ascites when shunt flow is questioned. A nuclear medicine technologist performs image acquisition, and a nuclear medicine physician interprets the findings, typically in a hospital imaging department.
Report 78291 for the shunt-patency study, supported by documentation of the indication, the tracer administration and imaging performed, and the interpretation. Submit modifier 26 for the physician interpretation or modifier TC for the equipment and staff portion when billing those components separately. Without either modifier, the code represents the global service. The CMS facts supplied for this code identify separately priced professional and technical components.
CMS billing rules for 78291
- 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 RVU0.86 · 12%
- Practice expense (office) RVU6.02 · 86%
- Malpractice RVU0.09 · 1%
76
Medicare services in 2024 · #5100 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.
78291 compared with similar codes
Office rates for Iowa, from the same CMS release.
78299
No office rateUnlisted gi px dx nuc med
78299 is an unlisted GI diagnostic nuclear medicine code. 78291 is the specific code for peritoneovenous shunt patency imaging.
Compare 78291 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
Iowa →
Office / nonfacility
$213.90
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 78291 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
9,313
- Code
- 78291
- Physician work
- 0.86
- Practice expense
- 6.02
- Malpractice
- 0.09
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.86 | × 1.000 | 0.8600 |
| Practice expense | 6.02 | × 0.915 | 5.5083 |
| Malpractice | 0.09 | × 0.397 | 0.0357 |
| Total RVUs | 6.4040 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$213.90
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.86 | 1 |
| Practice expense | 6.02 | 0.915 |
| Malpractice | 0.09 | 0.397 |
(0.86 × 1 + 6.02 × 0.915 + 0.09 × 0.397) × $33.4009 = $213.90
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.
78291 billing questions
When should 78291 be selected instead of 78290?
Use 78291 when imaging evaluates flow through an existing peritoneovenous shunt. Code 78290 describes intestine imaging, not shunt patency.
Which modifiers identify the separate components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Billing without a component modifier represents the global service.
What documentation supports reporting 78291?
Document the clinical concern about the existing shunt, tracer administration, imaging performed, and the physician's interpretation of tracer passage.
Can this code be reported for shunt placement?
No. 78291 describes imaging to assess shunt patency, not the procedure to place a peritoneovenous shunt.
Should 78299 be used for a peritoneovenous shunt patency study?
78291 specifically describes this study. 78299 is an unlisted GI diagnostic nuclear medicine code, not the code for a defined shunt-patency examination.
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.
9,31078290,,Intestine imaging,A,,0.66,7.96,,7.96,NA,0.09,8.71,8.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.38,12.38,0.12
9,31178290,26,Intestine imaging,A,,0.66,0.23,,0.23,,0.04,0.93,0.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,31278290,TC,Intestine imaging,A,,0.00,7.73,,7.73,NA,0.05,7.78,7.78,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.15,12.15,0.08
9,31378291,,Pertl-ven shunt patency test,A,,0.86,6.02,,6.02,NA,0.09,6.97,6.97,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.45,12.45,0.14
9,31478291,26,Pertl-ven shunt patency test,A,,0.86,0.31,,0.31,,0.05,1.22,1.22,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,31578291,TC,Pertl-ven shunt patency test,A,,0.00,5.71,,5.71,NA,0.04,5.75,5.75,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.14,12.14,0.09
9,31678299,,Unlisted gi px dx nuc med,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136