$201.49–$226.25
Use 78262 for imaging directed at gastroesophageal reflux; 78261 evaluates for functioning gastric-type tissue outside the stomach.
On this page
CMS RVU26D · Effective 2026-10-01
78261 Gastric mucosa scan Medicare reimbursement rates in Pennsylvania
Nuclear medicine imaging to locate functioning gastric-type tissue outside the stomach, commonly ordered when a Meckel diverticulum is suspected. Compare 78261 office and facility rates across CMS payment localities in Pennsylvania.
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 78261 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$170.52–$190.98
2 of 2 localities have a supported rate.
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 78261: Gastric-type mucosa localization scan
Nuclear medicine imaging to locate functioning gastric-type tissue outside the stomach, commonly ordered when a Meckel diverticulum is suspected.
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.
CMS billing rules for 78261
- 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 RVU0.67 · 12%
- Practice expense (office) RVU4.78 · 87%
- Malpractice RVU0.05 · 1%
15
Medicare services in 2024 · #6085 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.
78261 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$268.34–$301.67
78264 evaluates gastric emptying. It does not substitute for a study intended to localize ectopic gastric mucosa.
$268.96–$302.80
78290 is for intestine imaging. Choose 78261 when the target is ectopic functioning gastric mucosa rather than intestinal imaging generally.
Compare 78261 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$190.98
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$170.52
Facility
Unavailable
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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 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.
9,28478258,,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
9,28878261,26,Gastric mucosa imaging,A,,0.67,0.12,,0.12,,0.01,0.80,0.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,28978261,TC,Gastric mucosa imaging,A,,0.00,4.66,,4.66,NA,0.04,4.70,4.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.12,12.12,0.10
9,29078262,,Gastroesophageal reflux std,A,,0.66,5.77,,5.77,NA,0.08,6.51,6.51,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.38,12.38,0.13