$343.65
Both address hepatobiliary imaging, but 78227 is for a study with pharmacologic intervention; 78226 is for imaging without it.
On this page
CMS RVU26D · Effective 2026-10-01
78226 Hepatobiliary imaging Medicare reimbursement rates in Kentucky
Reports radiotracer imaging of bile flow through the liver and biliary system, including gallbladder visualization, for suspected obstruction, inflammation, or bile leak. Compare 78226 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 78226 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
$256.03
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 78226: Hepatobiliary nuclear medicine imaging
Reports radiotracer imaging of bile flow through the liver and biliary system, including gallbladder visualization, for suspected obstruction, inflammation, or bile leak.
This nuclear medicine study tracks an injected radiotracer as the liver takes it up and excretes it into the bile ducts, gallbladder when present, and bowel. A technologist acquires the gamma-camera images, and a radiologist or nuclear medicine physician interprets them. Common clinical questions include suspected acute cholecystitis, impaired bile flow, or a postoperative bile leak. The study is performed without the pharmacologic intervention represented by the related drug-assisted code.
Select this code for hepatobiliary imaging based on the documented study performed, not simply because the patient has a liver or gallbladder diagnosis. The order and report should support the clinical question and identify the imaging performed and findings. CMS recognizes separate professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service. The CMS file separately prices modifiers 26 and TC.
CMS billing rules for 78226
- 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 RVU0.72 · 8%
- Practice expense (office) RVU7.72 · 91%
- Malpractice RVU0.09 · 1%
42.8K
Medicare services in 2024 · #840 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.
78226 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$154.27
78201 is static liver imaging. Choose 78226 when the study follows tracer through the hepatobiliary system, including gallbladder visualization when performed.
$172.65
78202 adds vascular-flow assessment to liver imaging. It is not the hepatobiliary transit study described by 78226.
Compare 78226 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
$256.03
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 78226 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
9,269
- Code
- 78226
- Physician work
- 0.72
- Practice expense
- 7.72
- Malpractice
- 0.09
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.72 | × 1.000 | 0.7200 |
| Practice expense | 7.72 | × 0.889 | 6.8631 |
| Malpractice | 0.09 | × 0.915 | 0.0824 |
| Total RVUs | 7.6654 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$256.03
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.72 | 1 |
| Practice expense | 7.72 | 0.889 |
| Malpractice | 0.09 | 0.915 |
(0.72 × 1 + 7.72 × 0.889 + 0.09 × 0.915) × $33.4009 = $256.03
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.
78226 billing questions
When should 78227 be used instead?
Use 78227 when the hepatobiliary study includes a pharmacologic intervention. Use 78226 for the corresponding imaging without that intervention.
Is this the code for a HIDA scan?
It commonly describes a HIDA-type hepatobiliary study that follows radiotracer through the liver and biliary system. Confirm that the performed study does not include the drug intervention associated with 78227.
How should the professional and technical portions be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Billing without either modifier represents the global service.
What documentation supports reporting 78226?
The record should identify the clinical question, the hepatobiliary imaging performed, and the interpreting findings. The report should make clear whether pharmacologic intervention was part of the study.
Is 78226 the same as liver-only imaging?
No. 78226 evaluates radiotracer movement through the hepatobiliary system; 78201 is for static liver imaging, and 78202 includes vascular-flow imaging.
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.
9,26678216,,Lvr&spleen img w/vasc flow,A,,0.56,3.32,,3.32,NA,0.07,3.95,3.95,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.27,12.27,0.19
9,26778216,26,Lvr&spleen img w/vasc flow,A,,0.56,0.20,,0.20,,0.03,0.79,0.79,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,26878216,TC,Lvr&spleen img w/vasc flow,A,,0.00,3.12,,3.12,NA,0.04,3.16,3.16,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.07,12.07,0.16
9,26978226,,Hepatobiliary system imaging,A,,0.72,7.72,,7.72,NA,0.09,8.53,8.53,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.40,12.40,0.12
9,27078226,26,Hepatobiliary system imaging,A,,0.72,0.25,,0.25,,0.04,1.01,1.01,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,27178226,TC,Hepatobiliary system imaging,A,,0.00,7.47,,7.47,NA,0.05,7.52,7.52,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.15,12.15,0.08
9,27278227,,Hepatobil syst image w/drug,A,,0.88,10.46,,10.46,NA,0.12,11.46,11.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.79,16.79,0.16
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