CPT code 78740: Reflux study2026 Medicare rate & RVUs in Rhode Island
Reports radionuclide imaging of the bladder and upper urinary tract to evaluate suspected urine reflux from the bladder into the ureters.
Medicare pays $227.52 for 78740 in the office in Rhode Island (Rhode Island). 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 78740 covers
This nuclear medicine study evaluates whether urine flows backward from the bladder into the ureters, and sometimes toward the kidneys. A radiopharmaceutical is introduced into the bladder and images are obtained during filling and voiding. It is commonly used when vesicoureteral reflux is suspected, including in the evaluation of recurrent urinary tract infections, and may be performed in a nuclear medicine or radiology department. A nuclear medicine physician or radiologist interprets the images.
Select this code when the documented examination is a radionuclide ureteral reflux study, rather than imaging focused on renal drainage or bladder emptying. The record should support the reflux question and the imaging performed. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment-and-staff service; an unmodified claim represents the global service, including both components. CMS separately prices the 26 and TC 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.
78740 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $227.52 | Unavailable |
How the 78740 rate is calculated
Each of 78740’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 · 78740
RVUs × geographic indexes × conversion factor
Work0.56
0.56 RVUs× 1.000 GPCI
Practice expense5.99
5.99 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
6.6100
Conversion factor
$33.4009
Medicare rate
$220.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78740
The CMS indicators that decide how 78740 is paid alongside other services.
CMS payment indicators · 78740
Reflux study
| 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
78740 without 26 · national office
$220.78
Reflux study
78740-26 · Professional component
$27.05
Pays only the interpretation and report.
78740 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 74455Voiding study
- Use 78740 for the radionuclide reflux examination; 74455 is the fluoroscopic voiding cystourethrography service.
- 78708Renal imaging
- 78708 evaluates renal flow and function with a pharmacologic intervention; 78740 evaluates reflux from the bladder into the ureters.
- 78730Bladder ultrasound
- 78730 is a urinary bladder retention study. Choose 78740 when the diagnostic question is ureteral reflux, not retained bladder volume.
78740 billing questions
How does this differ from a fluoroscopic voiding cystourethrogram?
This code is for radionuclide imaging of reflux. CPT 74455 describes the fluoroscopic voiding cystourethrography approach.
When should modifier 26 or TC be used?
Use modifier 26 for the physician's interpretation and modifier TC for the technical service. Submit without either modifier when billing the global service.
What documentation supports this study?
Document the clinical concern for ureteral reflux and the radionuclide imaging performed to evaluate it. The report should support the physician's interpretation when billing modifier 26.
Is this the right code for a renal drainage study?
No. A study focused on renal flow or drainage, such as CPT 78708, is distinct from imaging for reflux from the bladder into the ureters.
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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