CPT 78227
Global XXX ActiveHepatobil syst image w/drug
CPT 78227 Billing & Documentation Guide
CPT code 78227 (Hepatobil syst image w/drug) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.88, a non-facility practice expense RVU of 10.46, and a malpractice RVU of 0.12, a total non-facility RVU of 11.46 and facility RVU of 11.46. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $398.04, though rates vary from $331.57 to $538.57 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78227, 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 78227 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 78227 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 78227
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.88 | 0.88 |
| Practice Expense RVU | 10.46 | 10.46 |
| Malpractice RVU | 0.12 | 0.12 |
| Total RVU | 11.46 | 11.46 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78227
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 | $446.02 | $446.02 | $414.95 - $538.57 | 29 |
| Florida | $387.73 | $387.73 | $369.42 - $403.23 | 3 |
| Georgia | $367.53 | $367.53 | $345.81 - $389.26 | 2 |
| Illinois | $374.74 | $374.74 | $354.64 - $395.51 | 4 |
| Michigan | $363.1 | $363.1 | $352.9 - $373.3 | 2 |
| North Carolina | $357.92 | $357.92 | $357.92 - $357.92 | 1 |
| New York | $426 | $426 | $364.12 - $454.12 | 5 |
| Ohio | $352.41 | $352.41 | $352.41 - $352.41 | 1 |
| Pennsylvania | $376.16 | $376.16 | $353.91 - $398.4 | 2 |
| Texas | $377.24 | $377.24 | $351.05 - $402.64 | 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 78227
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78227 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 76000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 78227
What does CPT code 78227 mean? +
CPT code 78227 represents: Hepatobil syst image w/drug. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78227? +
The 2026 Medicare national average non-facility payment for CPT 78227 is $398.04. Rates range from $331.57 to $538.57 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78227? +
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 78227? +
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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