$115.08
Choose 78191 for platelet survival and 78130 for red-cell survival; the tracked blood-cell type distinguishes the studies.
On this page
CMS RVU26D · Effective 2026-10-01
78191 Platelet study Medicare reimbursement rates in Kentucky
Reports a study that measures platelet survival over time to investigate shortened platelet lifespan or suspected platelet destruction and sequestration. Compare 78191 office and facility rates across CMS payment localities in Kentucky.
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 78191 in Kentucky?
Kentucky 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
$115.08
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 78191: Platelet survival and sequestration study
Reports a study that measures platelet survival over time to investigate shortened platelet lifespan or suspected platelet destruction and sequestration.
This diagnostic study evaluates how long platelets remain in circulation and may help investigate thrombocytopenia when shortened survival or sequestration is suspected. It involves studying the patient’s platelets over time; nuclear medicine and laboratory personnel may perform the technical work, while a physician interprets the findings. The study is distinct from imaging the spleen alone and from tests that track red blood cells.
Report 78191 for the platelet-survival study as a whole, supported by the order, records of the study performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation and a technical component for equipment and staff. Bill the professional work with modifier 26, the technical work with modifier TC, or the global service without either modifier when one entity provides both components. The documentation should identify the clinical question and support the component billed.
CMS billing rules for 78191
- 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 RVU0.59 · 16%
- Practice expense (office) RVU3.14 · 83%
- Malpractice RVU0.07 · 2%
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.
78191 compared with similar codes
Office rates for Kentucky, from the same CMS release.
Compare 78191 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
Kentucky →
Office / nonfacility
$115.08
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 78191 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
9,248
- Code
- 78191
- Physician work
- 0.59
- Practice expense
- 3.14
- Malpractice
- 0.07
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 3.14 | × 0.889 | 2.7915 |
| Malpractice | 0.07 | × 0.915 | 0.0641 |
| Total RVUs | 3.4455 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$115.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1 |
| Practice expense | 3.14 | 0.889 |
| Malpractice | 0.07 | 0.915 |
(0.59 × 1 + 3.14 × 0.889 + 0.07 × 0.915) × $33.4009 = $115.08
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.
78191 billing questions
How is 78191 different from a red-cell survival study?
78191 evaluates platelet survival. Use 78130 when the study tracks red-cell survival instead.
When should modifier 26 or TC be reported?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical component. Report the global service without either modifier when both components are billed together.
What documentation supports the professional component?
The record should include the clinical question and the physician’s interpretation of the platelet-survival findings.
Does the technical component include the interpretation?
No. CMS identifies equipment and staff as the technical component; physician interpretation is the professional component.
Is this the code for spleen imaging?
No. 78191 evaluates platelet survival. 78185 is the spleen-imaging code when the service performed is imaging the spleen.
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.
9,24578185,,Spleen imaging,A,,0.39,4.18,,4.18,NA,0.05,4.62,4.62,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.18,12.18,0.13
9,24678185,26,Spleen imaging,A,,0.39,0.07,,0.07,,0.01,0.47,0.47,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,24778185,TC,Spleen imaging,A,,0.00,4.11,,4.11,NA,0.04,4.15,4.15,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.11,12.11,0.12
9,24878191,,Platelet survival study,A,,0.59,3.14,,3.14,NA,0.07,3.80,3.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,24978191,26,Platelet survival study,A,,0.59,0.11,,0.11,,0.01,0.71,0.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,25078191,TC,Platelet survival study,A,,0.00,3.03,,3.03,NA,0.06,3.09,3.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
9,25178195,,Lymph system imaging,A,,1.17,8.05,,8.05,NA,0.11,9.33,9.33,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.87,16.87,0.17
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631