CPT code 78018: Thyroid metastasis scan, whole body with additional imaging2026 Medicare rate & RVUs in South Dakota
Reports whole-body nuclear imaging with additional views to evaluate iodine-avid metastatic thyroid carcinoma, such as during staging or follow-up after thyroid cancer treatment.
In South Dakota, Medicare pays $273.56 for 78018 in the office.
Check a contract rate as a % of Medicare · 78018 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 78018 covers
This nuclear medicine study evaluates possible metastatic thyroid carcinoma throughout the body and includes imaging beyond the whole-body acquisition. It is commonly performed in nuclear medicine departments for patients with differentiated thyroid cancer, including after thyroidectomy when a clinician is assessing for iodine-avid disease. A nuclear medicine technologist acquires the images, and a qualified physician interprets them.
Report 78018 when the documented examination includes whole-body imaging and additional imaging; use the documented extent and acquisitions to distinguish it from limited-area or whole-body-only studies. The record should support the thyroid cancer indication, the imaging performed, and the physician’s interpretation. Medicare recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier for 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.
How South Dakota compares for 78018
Across 109 of 109 payment localities, the office rate for 78018 runs from $239.63 in Arkansas to $385.32 in San Benito County, CA. South Dakota pays $273.56. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$273.56
- Los Angeles, CA · California$320.44+$46.88
- Washington, DC area · District of Columbia$320.93+$47.37
- Miami, FL · Florida$290.18+$16.62
- Chicago, IL · Illinois$280.87+$7.31
- Manhattan, NY · New York$318.72+$45.16
- Alaska · Alaska$304.13+$30.57
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $243.69 | — |
| ArkansasArkansas | $239.63 | — |
| ArizonaArizona | $267.55 | — |
| Bakersfield, CACalifornia | $298.39 | — |
| Chico, CACalifornia | $298.11 | — |
| El Centro, CACalifornia | $298.13 | — |
| Fresno, CACalifornia | $298.11 | — |
| Hanford, CACalifornia | $298.11 | — |
| Madera, CACalifornia | $298.11 | — |
| Merced, CACalifornia | $298.11 | — |
| Modesto, CACalifornia | $298.11 | — |
| Napa, CACalifornia | $353.60 | — |
| Oxnard, CACalifornia | $319.71 | — |
| Redding, CACalifornia | $298.11 | — |
| Rest of CaliforniaCalifornia | $298.11 | — |
| Riverside, CACalifornia | $299.09 | — |
| Sacramento, CACalifornia | $315.03 | — |
| Salinas, CACalifornia | $313.91 | — |
| San Diego, CACalifornia | $322.94 | — |
| Marin County, CACalifornia | $376.84 | — |
| San Francisco, CACalifornia | $376.74 | — |
| San Benito County, CACalifornia | $385.32 | — |
| Santa Clara County, CACalifornia | $384.90 | — |
| San Luis Obispo, CACalifornia | $308.62 | — |
| Santa Cruz, CACalifornia | $327.32 | — |
| Santa Maria, CACalifornia | $315.53 | — |
| Santa Rosa, CACalifornia | $330.75 | — |
| Stockton, CACalifornia | $298.11 | — |
| Vallejo, CACalifornia | $353.45 | — |
| Visalia, CACalifornia | $298.11 | — |
| Yuba City, CACalifornia | $298.11 | — |
| ColoradoColorado | $290.88 | — |
| ConnecticutConnecticut | $295.58 | — |
| DelawareDelaware | $272.46 | — |
| Fort Lauderdale, FLFlorida | $281.16 | — |
| Rest of FloridaFlorida | $266.31 | — |
| Atlanta, GAGeorgia | $280.16 | — |
| Rest of GeorgiaGeorgia | $249.73 | — |
| Hawaii, Guam, HIHawaii | $307.79 | — |
| IowaIowa | $252.96 | — |
| IdahoIdaho | $254.41 | — |
| East St. Louis, ILIllinois | $259.05 | — |
| Rest of IllinoisIllinois | $255.98 | — |
| Suburban Chicago, ILIllinois | $284.68 | — |
| IndianaIndiana | $256.16 | — |
| KansasKansas | $250.59 | — |
| KentuckyKentucky | $248.16 | — |
| New Orleans, LALouisiana | $261.54 | — |
| Rest of LouisianaLouisiana | $247.31 | — |
| Metropolitan Boston, MAMassachusetts | $323.81 | — |
| Rest of MassachusettsMassachusetts | $288.35 | — |
| Baltimore area, MDMaryland | $294.57 | — |
| Rest of MarylandMaryland | $278.53 | — |
| Rest of MaineMaine | $254.86 | — |
| Southern Maine, MEMaine | $272.25 | — |
| Detroit, MIMichigan | $269.06 | — |
| Rest of MichiganMichigan | $254.67 | — |
| MinnesotaMinnesota | $280.53 | — |
| Metropolitan Kansas City, MOMissouri | $260.57 | — |
| Metropolitan St. Louis, MOMissouri | $263.83 | — |
| Rest of MissouriMissouri | $241.74 | — |
| MississippiMississippi | $240.79 | — |
| MontanaMontana | $275.55 | — |
| North CarolinaNorth Carolina | $258.09 | — |
| North DakotaNorth Dakota | $273.77 | — |
| NebraskaNebraska | $254.86 | — |
| New HampshireNew Hampshire | $285.21 | — |
| Northern New JerseyNew Jersey | $316.65 | — |
| Rest of New JerseyNew Jersey | $299.46 | — |
| New MexicoNew Mexico | $255.87 | — |
| NevadaNevada | $275.30 | — |
| NYC suburbs and Long Island, NYNew York | $326.14 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $300.68 | — |
| Queens, NYNew York | $323.18 | — |
| Rest of New YorkNew York | $262.44 | — |
| OhioOhio | $254.31 | — |
| OklahomaOklahoma | $248.73 | — |
| Portland, OROregon | $302.38 | — |
| Rest of OregonOregon | $273.69 | — |
| Metropolitan Philadelphia, PAPennsylvania | $286.67 | — |
| Rest of PennsylvaniaPennsylvania | $255.34 | — |
| Puerto RicoPuerto Rico | $278.20 | — |
| Rhode IslandRhode Island | $283.83 | — |
| South CarolinaSouth Carolina | $256.52 | — |
| TennesseeTennessee | $251.92 | — |
| Austin, TXTexas | $289.45 | — |
| Beaumont, TXTexas | $253.34 | — |
| Brazoria, TXTexas | $272.92 | — |
| Dallas, TXTexas | $274.41 | — |
| Fort Worth, TXTexas | $272.00 | — |
| Galveston, TXTexas | $273.55 | — |
| Houston, TXTexas | $275.20 | — |
| Rest of TexasTexas | $262.80 | — |
| UtahUtah | $260.58 | — |
| VirginiaVirginia | $270.52 | — |
| Virgin Islands, VIUnited States Virgin Islands | $278.20 | — |
| VermontVermont | $271.63 | — |
| Rest of WashingtonWashington | $288.16 | — |
| King County, WAWashington | $331.91 | — |
| WisconsinWisconsin | $263.21 | — |
| West VirginiaWest Virginia | $244.82 | — |
| WyomingWyoming | $274.78 | — |
78018 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$239.63
$341.72
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $304.13 | 1 |
| AL | $243.69 | 1 |
| AR | $239.63 | 1 |
| AZ | $267.55 | 1 |
| CA | $298.11–$385.32 | 29 |
| CO | $290.88 | 1 |
| CT | $295.58 | 1 |
| DC | $320.93 | 1 |
| DE | $272.46 | 1 |
| FL | $266.31–$290.18 | 3 |
| GA | $249.73–$280.16 | 2 |
| GU | $307.79 | 1 |
| HI | $307.79 | 1 |
| IA | $252.96 | 1 |
| ID | $254.41 | 1 |
| IL | $255.98–$284.68 | 4 |
| IN | $256.16 | 1 |
| KS | $250.59 | 1 |
| KY | $248.16 | 1 |
| LA | $247.31–$261.54 | 2 |
| MA | $288.35–$323.81 | 2 |
| MD | $278.53–$320.93 | 3 |
| ME | $254.86–$272.25 | 2 |
| MI | $254.67–$269.06 | 2 |
| MN | $280.53 | 1 |
| MO | $241.74–$263.83 | 3 |
| MS | $240.79 | 1 |
| MT | $275.55 | 1 |
| NC | $258.09 | 1 |
| ND | $273.77 | 1 |
| NE | $254.86 | 1 |
| NH | $285.21 | 1 |
| NJ | $299.46–$316.65 | 2 |
| NM | $255.87 | 1 |
| NV | $275.30 | 1 |
| NY | $262.44–$326.14 | 5 |
| OH | $254.31 | 1 |
| OK | $248.73 | 1 |
| OR | $273.69–$302.38 | 2 |
| PA | $255.34–$286.67 | 2 |
| PR | $278.20 | 1 |
| RI | $283.83 | 1 |
| SC | $256.52 | 1 |
| SD | $273.56 | 1 |
| TN | $251.92 | 1 |
| TX | $253.34–$289.45 | 8 |
| UT | $260.58 | 1 |
| VA | $270.52–$320.93 | 2 |
| VI | $278.20 | 1 |
| VT | $271.63 | 1 |
| WA | $288.16–$331.91 | 2 |
| WI | $263.21 | 1 |
| WV | $244.82 | 1 |
| WY | $274.78 | 1 |
How the 78018 rate is calculated
Each of 78018’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 · 78018
RVUs × geographic indexes × conversion factor
Work0.84
0.84 RVUs× 1.000 GPCI
Practice expense7.32
7.32 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
8.2500
Conversion factor
$33.4009
Medicare rate
$275.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,194
- Code
- 78018
- Physician work
- 0.84
- Practice expense
- 7.32
- Malpractice
- 0.09
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.84 | × 1.000 | 0.8400 |
| Practice expense | 7.32 | × 1.000 | 7.3200 |
| Malpractice | 0.09 | × 0.336 | 0.0302 |
| Total RVUs | 8.1902 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$273.56
Office: (0.84 × 1 + 7.32 × 1 + 0.09 × 0.336) × $33.4009 = $273.56
Payment rules and modifiers for 78018
The CMS indicators that decide how 78018 is paid alongside other services.
CMS payment indicators · 78018
Thyroid metastasis scan, whole body with additional imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
78018 without 26 · national office
$275.56
Thyroid metastasis scan, whole body with additional imaging
78018-26 · Professional component
$38.08
Pays only the interpretation and report.
How 78018 has changed in South Dakota
78018 · Office / nonfacility
$273.56
Effective 2026-10-01
The base rate is $3.90 higher than on 2025-10-01, moving from $269.66 to $273.56 (1.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$269.66changed to$273.56
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.86 changed to 0.84
- Practice expense RVU 7.45 changed to 7.32
- Malpractice RVU 0.07 changed to 0.09
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$281.96changed to$269.66
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.58 changed to 7.45
- Malpractice RVU 0.08 changed to 0.07
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$277.36changed to$281.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$293.09changed to$277.36
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.76 changed to 7.58
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$305.27changed to$293.09
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.93 changed to 7.76
- Malpractice RVU 0.09 changed to 0.08
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$320.01changed to$305.27
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.28 changed to 7.93
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$321.54changed to$320.01
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.02 changed to 8.28
- Malpractice RVU 0.08 changed to 0.09
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$323.67changed to$321.54
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.09 changed to 8.02
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$328.36changed to$323.67
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.23 changed to 8.09
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$327.00changed to$328.36
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.22 changed to 8.23
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$324.46changed to$327.00
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.17 changed to 8.22
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$323.55changed to$324.46
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.12 changed to 8.17
- Malpractice RVU 0.06 changed to 0.08
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$321.94changed to$323.55
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$318.07changed to$321.94
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 7.99 changed to 8.12
- Malpractice RVU 0.07 changed to 0.06
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$320.85changed to$318.07
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 8.54 changed to 7.99
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $320.85
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $273.56 | Not available in this setting | RVU26D |
| 2026-07-01 | $273.56 | Not available in this setting | RVU26C |
| 2026-04-01 | $273.56 | Not available in this setting | RVU26B |
| 2026-01-01 | $273.56 | Not available in this setting | RVU26A |
| 2025-10-01 | $269.66 | Not available in this setting | RVU25D |
| 2025-07-01 | $269.66 | Not available in this setting | RVU25C |
| 2025-04-01 | $269.66 | Not available in this setting | RVU25B |
| 2025-01-01 | $269.66 | Not available in this setting | RVU25A |
| 2024-10-01 | $281.96 | Not available in this setting | RVU24D |
| 2024-07-01 | $281.96 | Not available in this setting | RVU24C |
| 2024-04-01 | $281.96 | Not available in this setting | RVU24B |
| 2024-03-09 | $281.96 | Not available in this setting | RVU24AR |
| 2024-01-01 | $277.36 | Not available in this setting | RVU24A |
| 2023-10-01 | $293.09 | Not available in this setting | RVU23D |
| 2023-07-01 | $293.09 | Not available in this setting | RVU23C |
| 2023-04-01 | $293.09 | Not available in this setting | RVU23B |
| 2023-01-01 | $293.09 | Not available in this setting | RVU23A |
| 2022-10-01 | $305.27 | Not available in this setting | RVU22D |
| 2022-07-01 | $305.27 | Not available in this setting | RVU22C |
| 2022-04-01 | $305.27 | Not available in this setting | RVU22B |
| 2022-01-01 | $305.27 | Not available in this setting | RVU22A |
| 2021-10-01 | $320.01 | Not available in this setting | RVU21D |
| 2021-07-01 | $320.01 | Not available in this setting | RVU21C |
| 2021-04-01 | $320.01 | Not available in this setting | RVU21B |
| 2021-01-01 | $320.01 | Not available in this setting | RVU21A |
| 2020-10-01 | $321.54 | Not available in this setting | RVU20D |
| 2020-07-01 | $321.54 | Not available in this setting | RVU20C |
| 2020-04-01 | $321.54 | Not available in this setting | RVU20B |
| 2020-01-01 | $321.54 | Not available in this setting | RVU20A |
| 2019-10-01 | $323.67 | Not available in this setting | RVU19D |
| 2019-07-01 | $323.67 | Not available in this setting | RVU19C |
| 2019-04-01 | $323.67 | Not available in this setting | RVU19B |
| 2019-01-01 | $323.67 | Not available in this setting | RVU19A |
| 2018-10-01 | $328.36 | Not available in this setting | RVU18D |
| 2018-07-01 | $328.36 | Not available in this setting | RVU18C |
| 2018-04-01 | $328.36 | Not available in this setting | RVU18B |
| 2018-01-01 | $328.36 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $327.00 | Not available in this setting | RVU17D |
| 2017-07-01 | $327.00 | Not available in this setting | RVU17C |
| 2017-04-01 | $327.00 | Not available in this setting | RVU17B |
| 2017-01-01 | $327.00 | Not available in this setting | RVU17A |
| 2016-10-01 | $324.46 | Not available in this setting | RVU16D |
| 2016-07-01 | $324.46 | Not available in this setting | RVU16C |
| 2016-04-01 | $324.46 | Not available in this setting | RVU16B |
| 2016-01-01 | $324.46 | Not available in this setting | RVU16A |
| 2015-10-01 | $323.55 | Not available in this setting | RVU15D |
| 2015-07-01 | $323.55 | Not available in this setting | RVU15C |
| 2015-04-01 | $321.94 | Not available in this setting | RVU15B |
| 2015-01-01 | $321.94 | Not available in this setting | RVU15A |
| 2014-10-01 | $318.07 | Not available in this setting | RVU14D |
| 2014-07-01 | $318.07 | Not available in this setting | RVU14C |
| 2014-04-01 | $318.07 | Not available in this setting | RVU14B |
| 2014-01-01 | $318.07 | Not available in this setting | RVU14A |
| 2013-10-01 | $320.85 | Not available in this setting | RVU13D |
| 2013-07-01 | $320.85 | Not available in this setting | RVU13C |
| 2013-04-01 | $320.85 | Not available in this setting | RVU13B |
| 2013-01-01 | $320.85 | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
78018 billing questions
How does 78018 differ from 78016?
78018 describes whole-body imaging with additional imaging. 78016 is the whole-body metastasis imaging option without that additional imaging distinction.
When should 78015 be used instead?
Use 78015 for thyroid carcinoma metastasis imaging limited to an area rather than a whole-body examination.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician’s interpretation or modifier TC for the technical service; without either modifier, the claim represents the global service.
What documentation supports 78018?
Document the thyroid carcinoma indication, the whole-body acquisition, the additional imaging performed, and the interpreting physician’s findings.
Is 78018 the right code for uptake measurement alone?
No. 78018 reports metastasis imaging with whole-body and additional imaging; 78020 is the related uptake-only option.
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
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