$195.82
78258 evaluates esophageal transit by radionuclide imaging; 78262 is focused on gastroesophageal reflux.
On this page
CMS RVU26D · Effective 2026-10-01
78258 Esophageal motility Medicare reimbursement rates in Kentucky
Reports radionuclide assessment of esophageal transit when a clinician evaluates impaired esophageal movement, such as in a patient with dysphagia. Compare 78258 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 78258 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
$185.35
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 78258: Nuclear esophageal transit study
Reports radionuclide assessment of esophageal transit when a clinician evaluates impaired esophageal movement, such as in a patient with dysphagia.
This nuclear medicine study evaluates how material moves through the esophagus. The patient swallows a radiotracer-containing bolus while a gamma camera records its passage; the resulting images help assess esophageal transit in a patient with symptoms such as dysphagia or suspected motility impairment. Nuclear medicine staff typically perform the imaging, and a physician interprets the findings. It is distinct from pressure-based esophageal manometry.
Report the study when the record supports a radionuclide evaluation of esophageal movement, rather than a reflux or gastric-emptying assessment. Documentation should identify the clinical reason, the imaging performed, and the physician’s interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Reporting without either modifier represents the global service.
CMS billing rules for 78258
- 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 · 12%
- Practice expense (office) RVU5.35 · 87%
- Malpractice RVU0.08 · 1%
85
Medicare services in 2024 · #5003 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.
78258 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$223.26
Report 91010 for catheter-based esophageal pressure and motility measurement. Report 78258 for radionuclide imaging of esophageal transit.
$260.67
78264 evaluates gastric emptying, not movement through the esophagus. Select according to the anatomic region and functional question studied.
Compare 78258 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
$185.35
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 78258 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
9,284
- Code
- 78258
- Physician work
- 0.72
- Practice expense
- 5.35
- Malpractice
- 0.08
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 | 5.35 | × 0.889 | 4.7561 |
| Malpractice | 0.08 | × 0.915 | 0.0732 |
| Total RVUs | 5.5493 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$185.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.72 | 1 |
| Practice expense | 5.35 | 0.889 |
| Malpractice | 0.08 | 0.915 |
(0.72 × 1 + 5.35 × 0.889 + 0.08 × 0.915) × $33.4009 = $185.35
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.
78258 billing questions
How is this different from esophageal manometry?
This code represents radionuclide imaging of esophageal transit. Manometry, reported with 91010, measures pressure and coordination using a catheter rather than imaging a swallowed tracer.
When should 78262 be considered instead?
Use 78262 for a radionuclide study focused on gastroesophageal reflux. Use 78258 when the clinical question is esophageal movement or transit.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician’s interpretation or modifier TC for the equipment and staff portion. Without either modifier, the claim represents the global service.
What documentation supports reporting 78258?
The record should support a radionuclide esophageal transit evaluation and include the clinical indication, imaging performed, and interpretation. Dysphagia or suspected impaired esophageal movement may support the study when documented.
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.
9,28178232,,Salivary gland function std,A,,0.46,2.58,,2.58,NA,0.05,3.09,3.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.11,12.11,0.20
9,28278232,26,Salivary gland function std,A,,0.46,0.08,,0.08,,0.01,0.55,0.55,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,28378232,TC,Salivary gland function std,A,,0.00,2.50,,2.50,NA,0.04,2.54,2.54,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.03,12.03,0.19
9,28478258,,Esophageal motility,A,,0.72,5.35,,5.35,NA,0.08,6.15,6.15,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.38,12.38,0.14
9,28578258,26,Esophageal motility,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
9,28678258,TC,Esophageal motility,A,,0.00,5.10,,5.10,NA,0.04,5.14,5.14,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.13,12.13,0.10
9,28778261,,Gastric mucosa imaging,A,,0.67,4.78,,4.78,NA,0.05,5.50,5.50,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.24,12.24,0.11
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