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CPT code 78020: Thyroid uptake, whole-body metastasis measurement2026 Medicare rate & RVUs in Puerto Rico

Reports quantitative whole-body radioactive iodine uptake measurement for thyroid carcinoma, as an add-on to the related whole-body metastasis imaging service.

CMS RVU26DEffective Oct 1, 2026One payment locality648 Medicare services in 2024

In Puerto Rico, Medicare pays $79.78 for 78020 in the office.

$79.78Office (non-facility)
Not available in this settingHospital or facility
+0.8%vs the national office rate ($79.16)

Check a contract rate as a % of Medicare · 78020 nationwide

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

We’ll open 78020 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 78020 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 78020 covers

This add-on captures a quantitative whole-body uptake measurement after radioactive iodine administration in a patient being evaluated for thyroid carcinoma metastases. It commonly accompanies nuclear medicine imaging in follow-up of differentiated thyroid cancer, including assessment for iodine-avid residual or metastatic disease. Nuclear medicine technologists perform the acquisition and measurement, with a nuclear medicine physician interpreting the findings.

Report 78020 only with the primary whole-body thyroid carcinoma metastasis imaging service, 78018. The record should support the clinical indication, radioactive tracer administration, measured uptake, and physician interpretation. CMS treats this as an add-on paid within the primary procedure’s global period. The global service may be billed without a component modifier; modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff.

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 Puerto Rico compares for 78020

Across 109 of 109 payment localities, the office rate for 78020 runs from $70.32 in Arkansas to $106.40 in San Benito County, CA. Puerto Rico pays $79.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

78020 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$79.78
  2. Los Angeles, CA · California$90.15+$10.37
  3. Washington, DC area · District of Columbia$90.72+$10.94
  4. Miami, FL · Florida$83.59+$3.81
  5. Chicago, IL · Illinois$81.32+$1.54
  6. Manhattan, NY · New York$90.62+$10.84
  7. Alaska · Alaska$92.19+$12.41

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

78020 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$71.32—
ArkansasArkansas$70.32—
ArizonaArizona$77.17—
Bakersfield, CACalifornia$84.59—
Chico, CACalifornia$84.45—
El Centro, CACalifornia$84.46—
Fresno, CACalifornia$84.45—
Hanford, CACalifornia$84.45—

78020 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$70.32

$95.43

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78020 office rate range by state
State / territoryOffice rate rangeLocalities
AK$92.191
AL$71.321
AR$70.321
AZ$77.171
CA$84.45–$106.4029
CO$82.821
CT$84.311
DC$90.721
DE$78.431
FL$77.27–$83.593
GA$73.14–$80.422
GU$86.561
HI$86.561
IA$73.411
ID$73.811
IL$74.86–$81.904
IN$74.231
KS$72.921
KY$72.601
LA$72.42–$75.912
MA$82.28–$91.102
MD$79.95–$90.723
ME$74.01–$78.142
MI$74.28–$78.042
MN$79.901
MO$71.11–$76.373
MS$70.731
MT$79.161
NC$74.781
ND$78.371
NE$73.851
NH$81.381
NJ$85.42–$89.792
NM$74.601
NV$79.001
NY$75.86–$92.555
OH$74.111
OK$72.641
OR$78.53–$85.582
PA$74.32–$82.162
PR$79.781
RI$81.311
SC$74.541
SD$78.271
TN$73.251
TX$73.83–$82.428
UT$75.541
VA$77.78–$90.722
VI$79.781
VT$77.921
WA$82.18–$93.092
WI$75.791
WV$72.121
WY$78.811

See 78020 in every payment locality

How the 78020 rate is calculated

Each of 78020’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 · 78020

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense1.74

1.74 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.3700

Conversion factor

$33.4009

Medicare rate

$79.16

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,197

Code
78020
Physician work
0.59
Practice expense
1.74
Malpractice
0.04

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 78020 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense1.74× 1.0111.7591
Malpractice0.04× 0.9850.0394
Total RVUs2.3885
Conversion factor× 33.4009

Office rate, Puerto Rico$79.78

Office: (0.59 × 1 + 1.74 × 1.011 + 0.04 × 0.985) × $33.4009 = $79.78

Open 78020 in the RVU calculator

Payment rules and modifiers for 78020

The CMS indicators that decide how 78020 is paid alongside other services.

CMS payment indicators · 78020

Thyroid uptake, whole-body metastasis measurement

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
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

78020 without 26 · national office

$79.16

Thyroid uptake, whole-body metastasis measurement

78020-26 · Professional component

$26.05

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78020

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78020
CodeHow it relatesOffice range, Puerto Rico
Primary code
78018Thyroid metastasis scan, whole body with additional imagingPrimary whole-body thyroid carcinoma metastasis imaging service required with this uptake measurement.$278.20
Same family
78015Thyroid metastasis imaging, limited anatomic areaThyroid carcinoma metastasis imaging code for a limited area rather than a whole-body uptake measurement.$206.02
78016Thyroid metastasis imaging, whole bodyRelated thyroid carcinoma metastasis imaging code; distinguishes imaging or studies from the uptake measurement.$253.92
Used instead
78012Thyroid uptake, uptake measurement onlyThyroid uptake measurement for a different clinical evaluation, rather than whole-body thyroid carcinoma metastasis assessment.$80.94

How 78020 has changed in Puerto Rico

78020 · Office / nonfacility

$79.78

Effective 2026-10-01

The base rate is $2.75 higher than on 2025-10-01, moving from $77.03 to $79.78 (3.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $77.03changed to$79.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.59
    • Practice expense RVU 1.73 changed to 1.74
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $78.26changed to$77.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.70 changed to 1.73

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $76.99changed to$78.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $80.08changed to$76.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.71 changed to 1.70
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $79.63changed to$80.08

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $82.13changed to$79.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.72 changed to 1.71
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $84.57changed to$82.13

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.77 changed to 1.72

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $86.01changed to$84.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.73 changed to 1.77
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $87.29changed to$86.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.77 changed to 1.73
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $88.64changed to$87.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.81 changed to 1.77

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $77.44changed to$88.64

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.79 changed to 1.81
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $67.09changed to$77.44

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $67.07changed to$67.09

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.78 changed to 1.79

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $66.74changed to$67.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $64.52changed to$66.74

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.72 changed to 1.78
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $63.43changed to$64.52

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.85 changed to 1.72
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $63.43

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$79.78Not available in this settingRVU26D
2026-07-01$79.78Not available in this settingRVU26C
2026-04-01$79.78Not available in this settingRVU26B
2026-01-01$79.78Not available in this settingRVU26A
2025-10-01$77.03Not available in this settingRVU25D
2025-07-01$77.03Not available in this settingRVU25C
2025-04-01$77.03Not available in this settingRVU25B
2025-01-01$77.03Not available in this settingRVU25A
2024-10-01$78.26Not available in this settingRVU24D
2024-07-01$78.26Not available in this settingRVU24C
2024-04-01$78.26Not available in this settingRVU24B
2024-03-09$78.26Not available in this settingRVU24AR
2024-01-01$76.99Not available in this settingRVU24A
2023-10-01$80.08Not available in this settingRVU23D
2023-07-01$79.63Not available in this settingRVU23C
2023-04-01$79.63Not available in this settingRVU23B
2023-01-01$79.63Not available in this settingRVU23A
2022-10-01$82.13Not available in this settingRVU22D
2022-07-01$82.13Not available in this settingRVU22C
2022-04-01$82.13Not available in this settingRVU22B
2022-01-01$82.13Not available in this settingRVU22A
2021-10-01$84.57Not available in this settingRVU21D
2021-07-01$84.57Not available in this settingRVU21C
2021-04-01$84.57Not available in this settingRVU21B
2021-01-01$84.57Not available in this settingRVU21A
2020-10-01$86.01Not available in this settingRVU20D
2020-07-01$86.01Not available in this settingRVU20C
2020-04-01$86.01Not available in this settingRVU20B
2020-01-01$86.01Not available in this settingRVU20A
2019-10-01$87.29Not available in this settingRVU19D
2019-07-01$87.29Not available in this settingRVU19C
2019-04-01$87.29Not available in this settingRVU19B
2019-01-01$87.29Not available in this settingRVU19A
2018-10-01$88.64Not available in this settingRVU18D
2018-07-01$88.64Not available in this settingRVU18C
2018-04-01$88.64Not available in this settingRVU18B
2018-01-01$88.64Not available in this settingRVU18AR1
2017-10-01$77.44Not available in this settingRVU17D
2017-07-01$77.44Not available in this settingRVU17C
2017-04-01$77.44Not available in this settingRVU17B
2017-01-01$77.44Not available in this settingRVU17A
2016-10-01$67.09Not available in this settingRVU16D
2016-07-01$67.09Not available in this settingRVU16C
2016-04-01$67.09Not available in this settingRVU16B
2016-01-01$67.09Not available in this settingRVU16A
2015-10-01$67.07Not available in this settingRVU15D
2015-07-01$67.07Not available in this settingRVU15C
2015-04-01$66.74Not available in this settingRVU15B
2015-01-01$66.74Not available in this settingRVU15A
2014-10-01$64.52Not available in this settingRVU14D
2014-07-01$64.52Not available in this settingRVU14C
2014-04-01$64.52Not available in this settingRVU14B
2014-01-01$64.52Not available in this settingRVU14A
2013-10-01$63.43Not available in this settingRVU13D
2013-07-01$63.43Not available in this settingRVU13C
2013-04-01$63.43Not available in this settingRVU13B
2013-01-01$63.43Not available in this settingRVU13AR

Price 78020 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

78020 billing questions

Can 78020 be reported by itself?

No. It is an add-on and must be reported with the primary whole-body thyroid carcinoma metastasis imaging service, 78018.

How is 78020 different from 78018?

78018 represents the primary whole-body metastasis imaging service. 78020 adds the quantitative whole-body uptake measurement.

When should modifier 26 or TC be used?

Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.

What documentation supports 78020?

Document the thyroid carcinoma indication, radioactive tracer administration, whole-body uptake measurement, and the interpreting physician’s findings.

How does the primary procedure’s global period affect this add-on?

CMS pays 78020 within the global period of the primary procedure. It is reported with 78018, not as a separate standalone service.

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 78020PPRRVU2026_Oct_nonQPP.csv, line 9,197 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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