CPT 78725
Global XXX ActiveKidney function study
CPT 78725 Billing & Documentation Guide
CPT code 78725 (Kidney function study) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.37, a non-facility practice expense RVU of 2.55, and a malpractice RVU of 0.06, a total non-facility RVU of 2.98 and facility RVU of 2.98. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $103.21, though rates vary from $86.55 to $137.61 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78725, 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 78725 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 78725 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 78725
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.37 | 0.37 |
| Practice Expense RVU | 2.55 | 2.55 |
| Malpractice RVU | 0.06 | 0.06 |
| Total RVU | 2.98 | 2.98 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78725
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 | $114.67 | $114.67 | $106.99 - $137.61 | 29 |
| Florida | $101.72 | $101.72 | $96.8 - $106.09 | 3 |
| Georgia | $96.03 | $96.03 | $90.72 - $101.34 | 2 |
| Illinois | $98.53 | $98.53 | $93.25 - $103.47 | 4 |
| Michigan | $95.16 | $95.16 | $92.38 - $97.93 | 2 |
| North Carolina | $93.1 | $93.1 | $93.1 - $93.1 | 1 |
| New York | $110.69 | $110.69 | $94.68 - $118.14 | 5 |
| Ohio | $92.14 | $92.14 | $92.14 - $92.14 | 1 |
| Pennsylvania | $98.04 | $98.04 | $92.44 - $103.64 | 2 |
| Texas | $98.14 | $98.14 | $91.73 - $104.27 | 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 78725
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78725 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 78725
What does CPT code 78725 mean? +
CPT code 78725 represents: Kidney function study. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78725? +
The 2026 Medicare national average non-facility payment for CPT 78725 is $103.21. Rates range from $86.55 to $137.61 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78725? +
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 78725? +
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 June 1, 2026.
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