$175.61
Choose 78215 for liver-and-spleen imaging without vascular-flow acquisition; 78216 includes flow imaging.
On this page
CMS RVU26D · Effective 2026-10-01
78216 Liver-spleen scan Medicare reimbursement rates in Vermont
Nuclear medicine imaging of liver and spleen with vascular-flow acquisition, reported when a study evaluates perfusion along with radiopharmaceutical distribution in both organs. Compare 78216 office and facility rates across CMS payment localities in Vermont.
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 78216 in Vermont?
Vermont 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
$129.67
1 of 1 localities have a supported rate.
Payment area: Vermont
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 78216: Liver and spleen flow imaging
Nuclear medicine imaging of liver and spleen with vascular-flow acquisition, reported when a study evaluates perfusion along with radiopharmaceutical distribution in both organs.
This nuclear medicine examination records vascular flow to the liver and spleen, then obtains images showing radiopharmaceutical distribution in both organs. A gamma camera captures the study after tracer administration. It is typically performed in a hospital nuclear medicine department when the clinical question calls for perfusion information together with liver-and-spleen imaging; a nuclear medicine physician or radiologist interprets the images.
Select 78216 when the performed study images both liver and spleen and includes vascular-flow imaging. A liver-only flow examination or a static liver-spleen examination has a different code. The report and technical record should support the organs imaged, flow acquisition, tracer administration, and interpretation. CMS recognizes professional and technical components: bill modifier 26 for the physician’s interpretation, modifier TC for equipment and staff, or no component modifier for the global service. CMS separately prices modifiers 26 and TC.
CMS billing rules for 78216
- 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 RVU0.56 · 14%
- Practice expense (office) RVU3.32 · 84%
- Malpractice RVU0.07 · 2%
62
Medicare services in 2024 · #5225 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.
78216 compared with similar codes
Office rates for Vermont, from the same CMS release.
$189.17
78202 covers liver imaging with vascular flow. 78216 is for a study that images both the liver and spleen with flow.
$280.85
78226 is hepatobiliary system imaging, rather than the liver-and-spleen examination with vascular-flow acquisition represented by 78216.
Compare 78216 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
Vermont →
Office / nonfacility
$129.67
Facility
Unavailable
Need rates for a whole code list?
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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 78216 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
9,266
- Code
- 78216
- Physician work
- 0.56
- Practice expense
- 3.32
- Malpractice
- 0.07
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.56 | × 1.000 | 0.5600 |
| Practice expense | 3.32 | × 0.990 | 3.2868 |
| Malpractice | 0.07 | × 0.506 | 0.0354 |
| Total RVUs | 3.8822 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$129.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.56 | 1 |
| Practice expense | 3.32 | 0.99 |
| Malpractice | 0.07 | 0.506 |
(0.56 × 1 + 3.32 × 0.99 + 0.07 × 0.506) × $33.4009 = $129.67
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.
78216 billing questions
How does 78216 differ from 78215?
78216 includes vascular-flow imaging of the liver and spleen. 78215 describes liver-and-spleen imaging without that flow component.
When would 78202 be more appropriate?
Use 78202 when the vascular-flow examination images the liver without imaging the spleen. Choose 78216 when both organs are imaged with flow.
Can the interpretation and equipment portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical service. Without either modifier, the claim represents the global service.
Are the flow images separately reported from the liver-spleen images?
The vascular-flow acquisition and organ images are elements of this liver-spleen study. The code selection should reflect the complete examination performed.
What documentation supports 78216?
Document that both the liver and spleen were imaged, that vascular-flow images were obtained, and the interpreting physician’s findings.
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.
9,26378215,,Lvr&spleen img static only,A,,0.48,4.79,,4.79,NA,0.07,5.34,5.34,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.29,12.29,0.14
9,26478215,26,Lvr&spleen img static only,A,,0.48,0.17,,0.17,,0.03,0.68,0.68,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,26578215,TC,Lvr&spleen img static only,A,,0.00,4.62,,4.62,NA,0.04,4.66,4.66,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.12,12.12,0.11
9,26678216,,Lvr&spleen img w/vasc flow,A,,0.56,3.32,,3.32,NA,0.07,3.95,3.95,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.27,12.27,0.19
9,26778216,26,Lvr&spleen img w/vasc flow,A,,0.56,0.20,,0.20,,0.03,0.79,0.79,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,26878216,TC,Lvr&spleen img w/vasc flow,A,,0.00,3.12,,3.12,NA,0.04,3.16,3.16,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.07,12.07,0.16
9,26978226,,Hepatobiliary system imaging,A,,0.72,7.72,,7.72,NA,0.09,8.53,8.53,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.40,12.40,0.12
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817