CPT code 78013: Thyroid imaging, with blood-flow imaging2026 Medicare rate & RVUs in Maryland

Reports nuclear medicine imaging of the thyroid that includes blood-flow assessment, used to evaluate thyroid tissue distribution and suspected functional abnormalities.

CMS RVU26DEffective Oct 1, 20263 payment localities695 Medicare services in 2024

Medicare pays $167.81–$193.95 for 78013 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.

$167.81–$193.95Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Maryland
  2. What 78013 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 78013 covers

A nuclear medicine study captures images of the thyroid and includes a blood-flow phase. It can help evaluate the distribution of functioning thyroid tissue, including suspected autonomous tissue or ectopic thyroid tissue. A nuclear medicine physician or radiologist typically interprets the images after acquisition with a gamma camera in a hospital or imaging center.

Report 78013 when the service includes thyroid imaging with blood-flow assessment but does not include quantitative thyroid uptake measurement. The record should support the clinical reason for imaging and document the performed imaging protocol and interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Without either modifier, the claim represents the global service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 78013 pays more and less in Maryland

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$167.81 to $193.95

$167.81$180.88$193.95
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
78013 office and facility rates by payment locality
Payment localityOfficeFacility
Baltimore area, MD$177.71Unavailable
Rest of Maryland$167.81Unavailable
Washington, DC area$193.95Unavailable

How the 78013 rate is calculated

Each of 78013’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 78013

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.36

0.36 RVUs× 1.000 GPCI

Practice expense4.56

4.56 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

4.9700

Conversion factor

$33.4009

Medicare rate

$166.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 78013

The CMS indicators that decide how 78013 is paid alongside other services.

CMS payment indicators · 78013

Thyroid imaging, with blood-flow imaging

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78013 without 26 · national office

$166.00

Thyroid imaging, with blood-flow imaging

78013-26 · Professional component

$16.70

Pays only the interpretation and report.

When to use modifier 26

78013 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78013

    Thyroid imaging, with blood-flow imaging0.36 wRVU

    $166.00

  • 78014

    Thyroid scan, quantitative uptake measurement0.49 wRVU

    $210.76+$44.76

  • 78012

    Thyroid uptake, uptake measurement only0.19 wRVU

    $80.16−$85.84

  • 78015

    Thyroid metastasis imaging, limited anatomic area0.65 wRVU

    $204.08+$38.08

How to choose

78014Thyroid scanQuantitative uptake measurement
78014 includes thyroid uptake measurement with the imaging; 78013 represents imaging with blood-flow assessment without that uptake measurement.
78012Thyroid uptakeUptake measurement only
78012 reports quantitative thyroid uptake measurement alone. Choose 78013 when thyroid imaging with blood-flow assessment is performed instead.
78015Thyroid metastasis imagingLimited anatomic area
78015 is directed at imaging thyroid carcinoma metastases in a limited area, not imaging the thyroid gland with blood-flow assessment.

78013 billing questions

How does 78013 differ from 78014?

78013 represents thyroid imaging with blood-flow assessment. Use 78014 when the imaging service also includes one or more quantitative thyroid uptake measurements.

When should 78012 be considered instead?

78012 is for quantitative thyroid uptake measurement without the thyroid imaging service represented by 78013. Choose based on the service actually performed and documented.

When are modifiers 26 and TC appropriate?

Use modifier 26 for the physician's interpretation and modifier TC for the technical service, including equipment and staff. Billing without either modifier represents the global service.

What documentation supports reporting 78013?

Document the clinical reason for the thyroid study, the imaging performed including its blood-flow phase, and the physician's interpretation. The record should distinguish imaging from any separately performed uptake measurement.

Is 78013 the code for thyroid cancer metastasis imaging?

No. 78013 describes thyroid imaging with blood-flow assessment; 78015 is for imaging directed at thyroid carcinoma metastases in a limited area.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 78013PPRRVU2026_Oct_nonQPP.csv, line 9,182 (RVU26D)

Open CMS sourceHow we calculate rates

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