Billing code 78120: Red cell massMedicare rate & RVUs in Oregon
Reports a nuclear medicine study that measures circulating red cell mass in one determination, often to assess erythrocytosis or polycythemia.
Medicare pays $71.73–$79.21 for 78120 in the office in Oregon, from Rest Of Oregon to Portland. 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 78120 covers
This nuclear medicine study measures the patient’s circulating red cell mass using labeled red cells and blood sampling. It may be ordered when a clinician needs to determine whether an elevated hematocrit reflects increased red cell mass, as in evaluation of erythrocytosis or suspected polycythemia, rather than a change in plasma volume. Nuclear medicine personnel typically perform the technical work, with a qualified practitioner interpreting the results. The study may be performed in a hospital or an outpatient nuclear medicine department.
Report 78120 for a single red cell mass determination; the distinction from 78121 is whether the study includes multiple determinations. Documentation should identify the red cell mass study and support the single-determination service. Medicare recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or no component modifier for the global service. Red cell mass may be assessed with a separate plasma volume study when both measurements are performed and documented.
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 78120 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $79.21 | Unavailable |
| Rest Of Oregon | $71.73 | Unavailable |
How the 78120 rate is calculated
Each of 78120’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 · 78120
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.22Practice expense 1.90Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78120
The CMS indicators that decide how 78120 is paid alongside other services.
CMS payment indicators · 78120
Red cell mass
| 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
78120 without 26 · national office
$72.48
Red cell mass
78120-26 · Professional component
$9.02
Pays only the interpretation and report.
78120 compared with similar codes
Compare codes
78120 vs 78121 vs 78110 vs 78122: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78121Red cell mass
- 78120 is for a single red cell mass determination; 78121 is for multiple determinations.
- 78110Plasma volume
- 78110 measures plasma volume, while 78120 measures red cell mass. Both may be reported when both studies are performed.
- 78122Blood volume test
- 78122 represents whole blood volume determination; 78120 is specific to red cell mass.
78120 billing questions
When should 78120 be chosen instead of 78121?
Use 78120 for a single red cell mass determination. Use 78121 when the study includes multiple determinations.
Can a plasma volume study be reported with 78120?
Yes, when a plasma volume study is also performed and documented. Code 78110 describes a single plasma volume determination.
How are the professional and technical services reported?
Use modifier 26 for the interpretation and modifier TC for the equipment and staff. Without a component modifier, the claim represents the global service.
What documentation supports reporting 78120?
Document the red cell mass study performed and that it involved a single determination. The record should support the interpretation or technical work billed.
Does 78120 measure total blood volume?
No. It measures red cell mass; 78122 is the code for whole blood volume determination.
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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