$159.62
Use 78660 for imaging that follows tracer through tear drainage. Use 68810 when the service is mechanical nasolacrimal duct probing, with or without irrigation.
On this page
CMS RVU26D · Effective 2026-10-01
78660 Tear-flow imaging Medicare reimbursement rates in Wyoming
Tracks radioactive tracer through the tear drainage pathways to evaluate impaired lacrimal flow, including suspected obstruction causing persistent tearing. Compare 78660 office and facility rates across CMS payment localities in Wyoming.
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 78660 in Wyoming?
Wyoming 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
$132.17
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 78660: Lacrimal drainage nuclear imaging
Tracks radioactive tracer through the tear drainage pathways to evaluate impaired lacrimal flow, including suspected obstruction causing persistent tearing.
This nuclear medicine study follows tear drainage from the eye through the lacrimal pathways toward the nose. A radioactive tracer is placed in the tear film, and gamma camera images show its movement over time. It may be used when persistent tearing raises concern for impaired drainage. The study is typically performed in a hospital or imaging department by nuclear medicine staff, with a physician interpreting the images; ophthalmologists commonly evaluate the resulting findings alongside the eye examination.
Report the service when imaging of lacrimal tracer flow is performed, rather than a mechanical probing or irrigation procedure. Documentation should identify the clinical concern, the imaging performed, and the interpreted drainage findings. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional service or TC for the technical service. Reporting without either modifier represents the global service.
CMS billing rules for 78660
- 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 RVU0.52 · 13%
- Practice expense (office) RVU3.40 · 86%
- Malpractice RVU0.05 · 1%
48
Medicare services in 2024 · #5385 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.
78660 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This code describes imaging of tear flow; 68811 describes nasolacrimal duct probing performed under general anesthesia.
$371.26
Use 78660 for diagnostic tracer imaging. Use 68815 when probing includes insertion of a tube into the drainage pathway.
Compare 78660 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
Wyoming** →
Office / nonfacility
$132.17
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 78660 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
9,476
- Code
- 78660
- Physician work
- 0.52
- Practice expense
- 3.40
- Malpractice
- 0.05
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.52 | × 1.000 | 0.5200 |
| Practice expense | 3.40 | × 1.000 | 3.4000 |
| Malpractice | 0.05 | × 0.740 | 0.0370 |
| Total RVUs | 3.9570 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$132.17
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.52 | 1 |
| Practice expense | 3.4 | 1 |
| Malpractice | 0.05 | 0.74 |
(0.52 × 1 + 3.4 × 1 + 0.05 × 0.74) × $33.4009 = $132.17
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.
78660 billing questions
When is this code appropriate instead of lacrimal probing?
Use this code for nuclear imaging that tracks tear flow. Probing or irrigation codes describe a mechanical procedure on the lacrimal drainage system.
How are the professional and technical services reported?
Use modifier 26 for the physician’s interpretation and TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports the service?
Document the concern prompting the study, the imaging performed, and the physician’s interpretation of tracer movement through the tear drainage pathways.
Does this code describe treatment of a blocked tear duct?
No. It describes diagnostic imaging of tear flow; probing, irrigation, or tube insertion are separate lacrimal procedures.
Can the professional and technical components be billed separately?
Yes. CMS separately prices the professional and technical components when reported with modifier 26 or TC, respectively.
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.
9,47378650,,Csf leakage imaging,A,,0.59,6.68,,6.68,NA,0.07,7.34,7.34,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,39.35,39.35,0.37
9,47478650,26,Csf leakage imaging,A,,0.59,0.11,,0.11,,0.01,0.71,0.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,47578650,TC,Csf leakage imaging,A,,0.00,6.57,,6.57,NA,0.06,6.63,6.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,39.24,39.24,0.36
9,47678660,,Nuclear exam of tear flow,A,,0.52,3.40,,3.40,NA,0.05,3.97,3.97,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.17,12.17,0.16
9,47778660,26,Nuclear exam of tear flow,A,,0.52,0.09,,0.09,,0.01,0.62,0.62,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,47878660,TC,Nuclear exam of tear flow,A,,0.00,3.31,,3.31,NA,0.04,3.35,3.35,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.08,12.08,0.15
9,47978699,,Unlisted nrvs sys px dx nuc,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,