Billing code 79101: Radiopharmaceutical therapyMedicare rate & RVUs in Utah
Report 79101 for therapeutic radiopharmaceutical delivered intravenously, with the record identifying the treatment, administered agent, route, and professional or technical work.
Medicare pays $138.08 for 79101 in the office in Utah (Utah). 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 79101 covers
Code 79101 represents therapeutic delivery of a radiopharmaceutical through a vein. It is used when treatment requires intravenous administration rather than oral dosing or another delivery route. Nuclear medicine physicians and other qualified clinicians may provide the service in a hospital or outpatient nuclear medicine setting, with the radiopharmaceutical prepared and administered under appropriate clinical supervision. The treatment record should identify the agent, the therapeutic purpose, the intravenous route, and the administration performed.
Choose this code by the route of administration, not by the imaging used to assess the condition. Document the administered agent and activity, treatment date, and relevant administration details so the service can be distinguished from oral or nonintravenous therapy. CMS identifies separately priced professional and technical components: report modifier 26 for the professional interpretation and modifier TC for the technical portion involving equipment and staff. Report without either modifier for 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.
79101 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $138.08 | Unavailable |
How the 79101 rate is calculated
Each of 79101’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 · 79101
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.91Practice expense 2.28Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 79101
The CMS indicators that decide how 79101 is paid alongside other services.
CMS payment indicators · 79101
Radiopharmaceutical therapy
| 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
79101 without 26 · national office
$142.96
Radiopharmaceutical therapy
79101-26 · Professional component
$89.85
Pays only the interpretation and report.
79101 compared with similar codes
Compare codes
79101 vs 79005 vs 79200: national Medicare rates
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How to choose
79101 billing questions
How do I distinguish 79101 from oral radiopharmaceutical therapy?
Use 79101 when the therapeutic radiopharmaceutical is administered intravenously. Oral administration is represented by a different route-specific code.
Which modifiers identify the components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion involving equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 79101?
The record should identify the therapeutic agent, treatment purpose, intravenous route, administered activity, and date and details of administration.
Is 79101 selected by the drug or by the route?
Select it based on intravenous administration. The route distinguishes it from oral, intra-arterial, intracavitary, and other radiopharmaceutical therapy codes.
Does reporting 79101 without a modifier include both components?
Yes. CMS identifies an unmodified claim as the global service; modifiers 26 and TC separately identify the professional and technical portions.
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
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