Billing code 78230: Salivary imagingMedicare rate & RVUs in Washington
Reports nuclear medicine imaging of the salivary glands to assess gland visualization during evaluation of suspected salivary gland disease or dysfunction.
Medicare pays $165.09–$190.29 for 78230 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 78230 covers
This service uses a radiopharmaceutical and nuclear medicine imaging to evaluate the salivary glands. It may be ordered during workup of symptoms such as dry mouth or suspected gland disease. A nuclear medicine technologist typically performs the image acquisition in a hospital or imaging department, and a qualified physician interprets the study and documents the findings. This code represents routine salivary gland imaging, rather than serial imaging or a dedicated functional study.
Select the code based on the service performed: routine gland imaging is distinct from serial image acquisition and a salivary gland function study. The record should support the clinical reason for imaging, the acquisition performed, and the physician’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the 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.
Where 78230 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $165.09 | Unavailable |
| Seattle (King Cnty) | $190.29 | Unavailable |
How the 78230 rate is calculated
Each of 78230’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 · 78230
RVUs × geographic indexes × conversion factor
Work0.44
0.44 RVUs× 1.000 GPCI
Practice expense4.22
4.22 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
4.7300
Conversion factor
$33.4009
Medicare rate
$157.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78230
The CMS indicators that decide how 78230 is paid alongside other services.
CMS payment indicators · 78230
Salivary imaging
| 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
78230 without 26 · national office
$157.99
Salivary imaging
78230-26 · Professional component
$21.04
Pays only the interpretation and report.
78230 compared with similar codes
Compare codes · National
78230 vs 78231 vs 78232: Medicare rates
How to choose
78230 billing questions
How does this differ from 78231?
Use 78230 for routine salivary gland imaging. Code 78231 describes serial imaging, so the recorded acquisition should support that distinction.
When is 78232 more appropriate?
78232 is for a salivary gland function study. Choose it when the service performed is a function study rather than routine imaging.
Which modifiers identify the components?
Modifier 26 identifies the physician interpretation, and modifier TC identifies the technical service. Bill without either modifier for the global service.
What documentation supports reporting 78230?
The record should identify the clinical reason for the salivary gland study, the imaging performed, and the interpreting physician’s findings.
Can the radiopharmaceutical supply be reported separately?
When technetium-99m pertechnetate is used, A9512 identifies its diagnostic supply. Document the radiopharmaceutical administered and follow applicable billing requirements for the supply.
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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