Billing code 78802: Tumor imagingMedicare rate & RVUs in Massachusetts
Reports single-day whole-body nuclear medicine imaging to localize radiopharmaceutical-avid tumor activity, rather than imaging limited regions or using a multi-day protocol.
Medicare pays $282.89–$317.84 for 78802 in the office in Massachusetts, from Rest Of Massachusetts to Metropolitan Boston. 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 78802 covers
This code describes a nuclear medicine study in which a radiopharmaceutical is used to identify tumor-related activity throughout the body, with imaging performed on a single day. A nuclear medicine technologist acquires the images, and a qualified interpreting physician evaluates and reports the findings. The service is typically performed in a hospital or outpatient nuclear medicine department for tumor localization or assessment.
Select this code when the documented study covers the whole body and imaging occurs on one day; imaging limited to selected areas, SPECT, or a multi-day schedule points to a different code. The report should support the radiopharmaceutical study, whole-body coverage, imaging date, and interpretation. The injection procedure is represented separately by 78808 when performed and reportable. The service may be billed globally, or split between the interpretation with modifier 26 and the equipment and staff with modifier TC. CMS diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
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 78802 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $317.84 | Unavailable |
| Rest Of Massachusetts | $282.89 | Unavailable |
How the 78802 rate is calculated
Each of 78802’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 · 78802
RVUs × geographic indexes × conversion factor
Work0.78
0.78 RVUs× 1.000 GPCI
Practice expense7.23
7.23 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
8.0900
Conversion factor
$33.4009
Medicare rate
$270.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78802
The CMS indicators that decide how 78802 is paid alongside other services.
CMS payment indicators · 78802
Tumor imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
78802 without 26 · national office
$270.21
Tumor imaging
78802-26 · Professional component
$35.74
Pays only the interpretation and report.
78802 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78801Tumor imaging
- 78801 is for imaging two or more selected areas on one day; 78802 is for whole-body imaging on one day.
- 78804Tumor localization
- Both describe whole-body tumor-localization imaging, but 78804 is for imaging over two or more days.
- 78803Tumor SPECT
- 78803 identifies SPECT imaging of one area. 78802 describes a single-day whole-body study.
- 78830Tumor SPECT/CT
- 78830 describes tumor-localization SPECT imaging with CT for one area; 78802 is the single-day whole-body study.
78802 billing questions
How does 78802 differ from imaging of multiple body areas?
Use 78802 for a whole-body study performed on one day. Imaging of two or more selected areas is represented by 78801 rather than whole-body coverage.
When should 78804 be used instead?
78804 describes whole-body imaging performed over two or more days. The imaging schedule, not simply the number of images, distinguishes it from 78802.
Is the radiopharmaceutical injection included?
The injection procedure is represented by 78808 when performed and reportable. Document the injection separately from the imaging and interpretation.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
Does the multiple procedure reduction affect both components?
Yes. CMS diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
What documentation supports 78802?
Record the radiopharmaceutical study, whole-body coverage, the date imaging was performed, and the physician's interpretation. The documentation should distinguish a single-day whole-body protocol from a limited-area or multi-day study.
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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