$176.52
Use 78457 for a unilateral study and 78458 when imaging is performed bilaterally.
On this page
CMS RVU26D · Effective 2026-10-01
78457 Venous imaging Medicare reimbursement rates in Utah
Reports radionuclide venous thrombosis imaging of one side when a clinician needs imaging to assess venous flow and possible thrombus. Compare 78457 office and facility rates across CMS payment localities in Utah.
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 78457 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$158.70
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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 78457: Unilateral venous thrombosis imaging
Reports radionuclide venous thrombosis imaging of one side when a clinician needs imaging to assess venous flow and possible thrombus.
This nuclear medicine study uses a radiopharmaceutical and imaging to assess venous flow and identify findings relevant to venous thrombosis on one side. It may be ordered when a clinician is evaluating suspected venous clot; a nuclear medicine technologist performs image acquisition, and a qualified physician interprets the study. The code distinguishes a unilateral examination from the bilateral study in the same code family.
Report one unit for the unilateral study and document the side examined, the clinical question, the imaging performed, and the physician’s interpretation. The code has professional and technical components: report modifier 26 for interpretation, modifier TC for the equipment and staff service, or neither modifier when billing the global service. When multiple cardiovascular diagnostic procedures are performed, the CMS multiple procedure reduction applies to the technical component.
CMS billing rules for 78457
- 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.
- Multiple procedures
- Cardiovascular diagnostic multiple procedure reduction applies to the technical component.
Where the value comes from
- Work RVU0.75 · 15%
- Practice expense (office) RVU4.19 · 84%
- Malpractice RVU0.07 · 1%
63
Medicare services in 2024 · #5217 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.
78457 compared with similar codes
Office rates for Utah, from the same CMS release.
$269.04
78456 identifies acute venous thrombus imaging; 78457 is the unilateral venous thrombosis imaging code. Select based on the study performed and its documented purpose.
$110.07
93971 reports a unilateral venous duplex ultrasound examination. 78457 is radionuclide venous thrombosis imaging, a different imaging method.
Compare 78457 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.
1 of 1 payment localities
Utah →
Office / nonfacility
$158.70
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 78457 in Utah.
PPRRVU2026_Oct_nonQPP.csv
9,380
- Code
- 78457
- Physician work
- 0.75
- Practice expense
- 4.19
- Malpractice
- 0.07
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.75 | × 1.000 | 0.7500 |
| Practice expense | 4.19 | × 0.940 | 3.9386 |
| Malpractice | 0.07 | × 0.898 | 0.0629 |
| Total RVUs | 4.7515 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$158.70
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.75 | 1 |
| Practice expense | 4.19 | 0.94 |
| Malpractice | 0.07 | 0.898 |
(0.75 × 1 + 4.19 × 0.94 + 0.07 × 0.898) × $33.4009 = $158.70
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
78457 billing questions
How does 78457 differ from 78458?
78457 is for imaging on one side; 78458 is the bilateral study. The documented extent of the examination determines which code fits.
When should 78456 be considered instead?
78456 is the code identified for acute venous thrombus imaging. Use the code that matches the type of study performed and documented rather than choosing by code proximity.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Bill without either modifier when reporting the global service.
Does the multiple procedure reduction affect both components?
The CMS cardiovascular diagnostic multiple procedure reduction applies to the technical component. It does not apply to the professional component under the rule provided for this code.
What documentation supports a unilateral claim?
Document the side imaged, the clinical indication, the examination performed, and the interpretation. The record should support that the study covered one side rather than both.
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.
9,37778456,,Acute venous thrombus image,A,,0.98,7.45,,7.45,NA,0.08,8.51,8.51,1,XXX,0.00,0.00,0.00,6,9,9,9,9,9,,33.4009,09,0,99,39.68,39.68,0.31
9,37878456,26,Acute venous thrombus image,A,,0.98,0.36,,0.36,,0.03,1.37,1.37,1,XXX,0.00,0.00,0.00,6,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9,37978456,TC,Acute venous thrombus image,A,,0.00,7.09,,7.09,NA,0.05,7.14,7.14,1,XXX,0.00,0.00,0.00,6,9,9,9,9,9,,33.4009,09,0,99,39.32,39.32,0.28
9,38078457,,Venous thrombosis imaging,A,,0.75,4.19,,4.19,NA,0.07,5.01,5.01,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,16.72,16.72,0.20
9,38178457,26,Venous thrombosis imaging,A,,0.75,0.28,,0.28,,0.03,1.06,1.06,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,38278457,TC,Venous thrombosis imaging,A,,0.00,3.91,,3.91,NA,0.04,3.95,3.95,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,16.44,16.44,0.17
9,38378458,,Ven thrombosis images bilat,A,,0.88,4.60,,4.60,NA,0.09,5.57,5.57,1,XXX,0.00,0.00,0.00,6,2,0,0,0,9,,33.4009,09,0,99,12.43,12.43,0.16
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985