CPT 78195
Global XXX ActiveLymph system imaging
CPT 78195 Billing & Documentation Guide
CPT code 78195 (Lymph system imaging) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.17, a non-facility practice expense RVU of 8.05, and a malpractice RVU of 0.11, a total non-facility RVU of 9.33 and facility RVU of 9.33. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $323.63, though rates vary from $271.94 to $433.07 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78195, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 78195 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 78195 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 78195
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.17 | 1.17 |
| Practice Expense RVU | 8.05 | 8.05 |
| Malpractice RVU | 0.11 | 0.11 |
| Total RVU | 9.33 | 9.33 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78195
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $360.63 | $360.63 | $336.4 - $433.07 | 29 |
| Florida | $316 | $316 | $301.65 - $328.27 | 3 |
| Georgia | $300.05 | $300.05 | $283.3 - $316.79 | 2 |
| Illinois | $306.04 | $306.04 | $290.31 - $322 | 4 |
| Michigan | $296.73 | $296.73 | $288.71 - $304.74 | 2 |
| North Carolina | $292.29 | $292.29 | $292.29 - $292.29 | 1 |
| New York | $345.89 | $345.89 | $297.1 - $368.1 | 5 |
| Ohio | $288.27 | $288.27 | $288.27 - $288.27 | 1 |
| Pennsylvania | $306.73 | $306.73 | $289.38 - $324.07 | 2 |
| Texas | $307.41 | $307.41 | $287.17 - $326.88 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 78195
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78195 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0394T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0395T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 78195
What does CPT code 78195 mean? +
CPT code 78195 represents: Lymph system imaging. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78195? +
The 2026 Medicare national average non-facility payment for CPT 78195 is $323.63. Rates range from $271.94 to $433.07 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78195? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 78195? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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