CPT 78351
Global XXXBone mineral dual photon
CPT 78351 Billing & Documentation Guide
CPT code 78351 (Bone mineral dual photon) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.29, a non-facility practice expense RVU of 0.06, and a malpractice RVU of 0.02, a total non-facility RVU of 0.37 and facility RVU of 0.37. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $12.55, though rates vary from $11.75 to $17.03 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78351, 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 78351 with related codes; this code has 3 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Non-covered service
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 0 units of 78351 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 78351
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.29 | 0.29 |
| Practice Expense RVU | 0.06 | 0.06 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 0.37 | 0.37 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78351
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 | $12.77 | $12.77 | $12.41 - $14 | 29 |
| Florida | $13 | $13 | $12.61 - $13.46 | 3 |
| Georgia | $12.41 | $12.41 | $12.27 - $12.55 | 2 |
| Illinois | $12.93 | $12.93 | $12.56 - $13.3 | 4 |
| Michigan | $12.51 | $12.51 | $12.27 - $12.75 | 2 |
| North Carolina | $11.98 | $11.98 | $11.98 - $11.98 | 1 |
| New York | $13.29 | $13.29 | $12.06 - $13.93 | 5 |
| Ohio | $12.19 | $12.19 | $12.19 - $12.19 | 1 |
| Pennsylvania | $12.45 | $12.45 | $12.16 - $12.74 | 2 |
| Texas | $12.33 | $12.33 | $12.13 - $12.67 | 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 78351
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78351 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 78351
What does CPT code 78351 mean? +
CPT code 78351 represents: Bone mineral dual photon. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78351? +
The 2026 Medicare national average non-facility payment for CPT 78351 is $12.55. Rates range from $11.75 to $17.03 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78351? +
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 78351? +
This code has 3 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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