Billing code 78262: Reflux imagingMedicare rate & RVUs in Minnesota
Reports radionuclide imaging used to assess movement of stomach contents back into the esophagus during evaluation of suspected gastroesophageal reflux.
Medicare pays $221.15 for 78262 in the office in Minnesota (Minnesota). 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 78262 covers
A nuclear medicine technologist administers a radiolabeled liquid or meal by mouth and obtains serial gamma-camera images to look for retrograde movement from the stomach into the esophagus. A nuclear medicine physician interprets the images. The study may be performed in a hospital imaging department for patients, including infants and children, being evaluated for suspected gastroesophageal reflux.
Report 78262 when the study is directed at detecting reflux, rather than evaluating esophageal motility or gastric emptying. Documentation should identify the clinical indication, the imaging performed, and the physician’s interpretation and findings. CMS recognizes separately priced professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service.
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.
78262 in Minnesota
| Payment locality | Office | Facility |
|---|---|---|
| Minnesota | $221.15 | Unavailable |
How the 78262 rate is calculated
Each of 78262’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 · 78262
RVUs × geographic indexes × conversion factor
Work0.66
0.66 RVUs× 1.000 GPCI
Practice expense5.77
5.77 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
6.5100
Conversion factor
$33.4009
Medicare rate
$217.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78262
The CMS indicators that decide how 78262 is paid alongside other services.
CMS payment indicators · 78262
Reflux imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
78262 without 26 · national office
$217.44
Reflux imaging
78262-26 · Professional component
$31.40
Pays only the interpretation and report.
78262 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78258Esophageal motility
- 78262 assesses reflux from the stomach into the esophagus; 78258 evaluates esophageal motility.
- 78264Gastric emptying
- 78262 looks for reflux, while 78264 evaluates how quickly the stomach empties.
- 74220Esophagram
- 78262 uses radionuclide imaging to assess reflux; 74220 is a radiographic examination of the esophagus.
78262 billing questions
When should 78262 be selected instead of 78258?
Use 78262 for radionuclide assessment of reflux from the stomach into the esophagus. Code 78258 evaluates esophageal motility.
How are the professional and technical services reported?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
What documentation supports 78262?
Document the suspected reflux indication, the radionuclide imaging performed, and the interpreting physician’s findings and conclusion.
Is 78262 the code for a gastric emptying study?
No. Code 78262 assesses reflux into the esophagus; 78264 is used for gastric emptying imaging.
How does 78262 differ from an esophagram?
Code 78262 reports radionuclide imaging for reflux. An esophagram such as 74220 uses radiographic imaging to examine the esophagus.
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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