Billing code 78315: Bone imagingMedicare rate & RVUs in Utah

Reports a three-phase nuclear bone study that evaluates blood flow, soft-tissue activity, and delayed bone uptake in a targeted clinical assessment.

CMS RVU26DEffective Oct 1, 20261 payment locality31.1K Medicare services in 2024

Medicare pays $286.93 for 78315 in the office in Utah (Utah). Which amount applies depends on the service address.

$286.93Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 78315 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 78315 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 78315 covers

This study captures bone-related activity in three stages: blood flow, blood-pool or soft-tissue activity, and delayed skeletal uptake. Nuclear medicine technologists acquire the images, and a nuclear medicine physician or radiologist interprets them. Clinicians commonly request the study when assessing suspected osteomyelitis, a painful joint prosthesis, stress injury, or another focal bone or joint concern where the phases may help characterize the process.

Report 78315 when the performed protocol includes all three phases; a scan of several areas or a whole-body survey alone does not establish that the three-phase service was performed. The record should identify the clinical question and imaged region and support that the three phases were acquired and interpreted. This diagnostic test has 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.

78315 in Utah

78315 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$286.93Unavailable

How the 78315 rate is calculated

Each of 78315’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 · 78315

RVUs × geographic indexes × conversion factor

Work0.99

0.99 RVUs× 1.000 GPCI

Practice expense7.99

7.99 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

9.0800

Conversion factor

$33.4009

Medicare rate

$303.28

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 78315

The CMS indicators that decide how 78315 is paid alongside other services.

CMS payment indicators · 78315

Bone imaging

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78315 without 26 · national office

$303.28

Bone imaging

78315-26 · Professional component

$46.09

Pays only the interpretation and report.

When to use modifier 26

78315 compared with similar codes

Compare codes · National

4 codes, side by side

  • 78315

    Bone imaging0.99 wRVU

    $303.28

  • 78300

    Bone scan0.6 wRVU

    $199.40−$103.88

  • 78305

    Bone imaging0.81 wRVU

    $242.82−$60.46

  • 78306

    Bone imaging0.84 wRVU

    $259.19−$44.09

How to choose

78300Bone scan
78300 describes limited-area bone imaging. Choose 78315 when the examination includes the three phases, rather than selecting it solely because the images cover a small region.
78305Bone imaging
78305 describes imaging of multiple areas. 78315 is distinguished by its three-phase acquisition, not by the number of sites.
78306Bone imaging
78306 describes a whole-body bone study. 78315 identifies a three-phase protocol and is not selected simply because delayed images survey the skeleton.

78315 billing questions

When should 78315 be selected instead of a limited-area bone scan?

Select 78315 when the examination includes the blood-flow, blood-pool, and delayed phases. A limited-area scan describes imaging extent, not a three-phase protocol.

Which modifier identifies the interpretation?

Use modifier 26 for the professional component, which represents interpretation. Modifier TC identifies the technical component; billing without either modifier represents the global service.

What documentation supports 78315?

Document the clinical reason, the region examined, acquisition of all three phases, and the interpreting clinician’s findings.

Does imaging more than one region by itself support 78315?

No. The defining feature is the three-phase protocol, not the number of areas imaged.

Can 78315 be reported for delayed images alone?

No. The performed examination must include the three phases; delayed skeletal images alone do not describe this service.

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
RVUs for 78315PPRRVU2026_Oct_nonQPP.csv, line 9,328 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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