$282.71–$325.84
Both describe whole-body tumor-localization imaging. Choose 78804 when imaging spans two or more days and 78802 when the study is performed on one day.
On this page
CMS RVU26D · Effective 2026-10-01
78804 Tumor localization Medicare reimbursement rates in Washington
Reports whole-body radiopharmaceutical tumor-localization imaging when image acquisition extends across two or more days for the diagnostic study. Compare 78804 office and facility rates across CMS payment localities in Washington.
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 78804 in Washington?
Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$588.30–$680.94
2 of 2 localities have a supported rate.
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 78804: Whole-body tumor localization over multiple days
Reports whole-body radiopharmaceutical tumor-localization imaging when image acquisition extends across two or more days for the diagnostic study.
This code represents a nuclear medicine tumor-localization study in which a radiopharmaceutical is used to identify tumor-related activity throughout the body, with imaging performed on at least two days. Nuclear medicine technologists acquire the images, and a qualified physician interprets them. The service is typically performed in a hospital or outpatient nuclear medicine department when the diagnostic protocol calls for delayed or serial whole-body imaging rather than a single-day acquisition.
Select the code based on whole-body coverage and the multi-day imaging protocol, not simply the number of images. Documentation should identify the clinical indication, radiopharmaceutical, body coverage, imaging dates or timepoints, and the physician’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff portion, or neither modifier for the global service.
CMS billing rules for 78804
- 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 RVU0.98 · 6%
- Practice expense (office) RVU15.69 · 93%
- Malpractice RVU0.13 · 1%
807
Medicare services in 2024 · #3141 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.
78804 compared with similar codes
Office rates for Washington, from the same CMS release.
$242.28–$279.39
78800 is for one body area; 78804 is for whole-body imaging performed over two or more days.
$351.08–$404.24
78803 identifies SPECT tumor-localization imaging. Choose 78804 for a multi-day whole-body study when the service is not reported as the SPECT procedure.
Compare 78804 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.
2 of 2 payment localities
Rest Of Washington →
Office / nonfacility
$588.30
Facility
Unavailable
Seattle (King Cnty) →
Office / nonfacility
$680.94
Facility
Unavailable
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78804 billing questions
How does this differ from 78802?
78804 is for whole-body tumor-localization imaging performed over two or more days. Use 78802 when the whole-body study is completed on one day.
When should I choose 78800 or 78801 instead?
Those codes describe tumor-localization imaging of one area or multiple areas, rather than whole-body imaging. Choose according to the documented body coverage.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician’s interpretation or TC for the technical service; without either modifier, the claim represents the global service.
What documentation supports 78804?
Document the whole-body coverage, radiopharmaceutical, clinical indication, image-acquisition dates or timepoints, and the interpreting physician’s findings.
Is 78804 the right code for SPECT tumor imaging?
Use the applicable SPECT tumor-localization code when the service is SPECT-based. 78804 identifies a multi-day whole-body study, not SPECT imaging.
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.
9,52178803,,Rp loclzj tum spect 1 area,A,,1.06,8.89,,8.89,NA,0.10,10.05,10.05,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,16.87,16.87,0.15
9,52278803,26,Rp loclzj tum spect 1 area,A,,1.06,0.36,,0.36,,0.05,1.47,1.47,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
9,52378803,TC,Rp loclzj tum spect 1 area,A,,0.00,8.53,,8.53,NA,0.05,8.58,8.58,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,16.51,16.51,0.10
9,52478804,,Rp loclzj tum whbdy 2+d img,A,,0.98,15.69,,15.69,NA,0.13,16.80,16.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.84,16.84,0.14
9,52578804,26,Rp loclzj tum whbdy 2+d img,A,,0.98,0.32,,0.32,,0.05,1.35,1.35,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,52678804,TC,Rp loclzj tum whbdy 2+d img,A,,0.00,15.37,,15.37,NA,0.08,15.45,15.45,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.52,16.52,0.09
9,52778808,,Iv inj ra drug dx study,A,,0.18,1.02,,1.02,NA,0.03,1.23,1.23,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00