Salivary gland imaging
CPT 78230 covers nuclear medicine imaging of the salivary glands, which uses a small amount of radioactive tracer to evaluate gland function and detect blockages, tumors, or inflammatory conditions like Sjögren's syndrome.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
Loading bundling edits…
Billing tips
Verify that radiopharmaceutical administration (Tc-99m pertechnetate) is documented with dosage, route, and time of injection
Impact: Missing radiopharmaceutical documentation is the leading cause of denial, resulting in $157.20 payment loss
Document sialagogue stimulation timing and patient response if performed, as this demonstrates complete protocol execution
Impact: Incomplete functional assessment documentation can trigger medical necessity reviews and potential downcoding
Bill separately for radiopharmaceutical supply using appropriate A-code (A9512 for Tc-99m pertechnetate) in addition to CPT 78230
Impact: Radiopharmaceutical adds approximately $25-40 to total reimbursement when billed correctly
Confirm medical necessity with ICD-10 codes documenting specific salivary gland symptoms or suspected pathology, avoiding screening diagnoses
Impact: Screening indications or vague symptoms result in 30-40% denial rate for this procedure
For split billing scenarios, ensure facility and professional components equal the total 4.86 RVUs when combining 26 and TC modifiers
Impact: Incorrect component billing can result in overpayment recovery or underpayment of $50-100
Document total imaging time and number of phases acquired (typically dynamic, static, and post-stimulation images)
Impact: Abbreviated protocols without documented justification may be downcoded or denied as not medically reasonable
Common denials
Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.
Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.
Help build the field knowledge
MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.