Billing code 78261: Gastric mucosa scanMedicare rate & RVUs in Ohio
Nuclear medicine imaging to locate functioning gastric-type tissue outside the stomach, commonly ordered when a Meckel diverticulum is suspected.
Medicare pays $169.83 for 78261 in the office in Ohio (Ohio). 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 8 sections
What 78261 covers
This nuclear medicine study uses a radiotracer that is taken up by functioning gastric mucosa to identify gastric-type tissue in an abnormal location. A common clinical question is whether a child or adult with gastrointestinal bleeding has a Meckel diverticulum containing ectopic gastric mucosa. A nuclear medicine technologist performs the imaging, and a qualified physician interprets the images and reports the findings, commonly in a hospital or imaging facility.
Report 78261 when the study is directed at localizing ectopic functioning gastric mucosa, rather than measuring stomach emptying or evaluating reflux. The record should support the clinical indication and include the imaging findings and physician interpretation. CMS recognizes separately priced professional and technical components: report modifier 26 for the interpretation, TC for the equipment and staff portion, 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.
78261 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $169.83 | Unavailable |
How the 78261 rate is calculated
Each of 78261’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 · 78261
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.67Practice expense 4.78Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78261
The CMS indicators that decide how 78261 is paid alongside other services.
CMS payment indicators · 78261
Gastric mucosa scan
| 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
78261 without 26 · national office
$183.70
Gastric mucosa scan
78261-26 · Professional component
$26.72
Pays only the interpretation and report.
78261 compared with similar codes
Compare codes
78261 vs 78262 vs 78264 vs 78290: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78262Reflux imaging
- Use 78262 for imaging directed at gastroesophageal reflux; 78261 evaluates for functioning gastric-type tissue outside the stomach.
- 78264Gastric emptying
- 78264 evaluates gastric emptying. It does not substitute for a study intended to localize ectopic gastric mucosa.
- 78290Intestinal imaging
- 78290 is for intestine imaging. Choose 78261 when the target is ectopic functioning gastric mucosa rather than intestinal imaging generally.
78261 billing questions
When should 78261 be chosen over 78264?
Use 78261 to localize functioning gastric-type mucosa outside the stomach, such as in a suspected Meckel diverticulum. Use 78264 when the clinical question is how quickly the stomach empties.
How does 78261 differ from 78262?
78261 evaluates for ectopic gastric mucosa. 78262 is directed at gastroesophageal reflux.
How are the professional and technical services reported?
Report modifier 26 for the physician's interpretation or TC for the technical service. Billing without either modifier represents the global service.
What documentation supports reporting 78261?
Document the reason for evaluating ectopic gastric mucosa and the study findings, including the interpreting physician's conclusion about localization.
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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