Billing code 78018: Thyroid metastasis scanMedicare rate & RVUs
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.
Medicare pays $275.56 for 78018 nationally in the office. Local office rates run $239.63–$385.32.
Medicare rate · 78018
Thyroid metastasis scan
Swap in your local Medicare rate.
- Work RVUs
- 0.84
- Total RVUs
- 8.25
- Global days
- XXX
National rate · 2026
$275.56
Office setting, before claim adjustments.
See every locality for 78018 → · Billed by an NP, PA or therapist? →
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 10 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.
Where 78018 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$239.63 to $385.32
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $243.69 | Unavailable |
| Alaska* | $304.13 | Unavailable |
| Arizona | $267.55 | Unavailable |
| Arkansas | $239.63 | Unavailable |
| Atlanta | $280.16 | Unavailable |
| Austin | $289.45 | Unavailable |
| Bakersfield | $298.39 | Unavailable |
| Baltimore/Surr. Cntys | $294.57 | Unavailable |
| Beaumont | $253.34 | Unavailable |
| Brazoria | $272.92 | Unavailable |
| Chicago | $280.87 | Unavailable |
| Chico | $298.11 | Unavailable |
| Colorado | $290.88 | Unavailable |
| Connecticut | $295.58 | Unavailable |
| Dallas | $274.41 | Unavailable |
| Dc + Md/Va Suburbs | $320.93 | Unavailable |
| Delaware | $272.46 | Unavailable |
| Detroit | $269.06 | Unavailable |
| East St. Louis | $259.05 | Unavailable |
| El Centro | $298.13 | Unavailable |
| Fort Lauderdale | $281.16 | Unavailable |
| Fort Worth | $272.00 | Unavailable |
| Fresno | $298.11 | Unavailable |
| Galveston | $273.55 | Unavailable |
| Hanford-Corcoran | $298.11 | Unavailable |
| Hawaii, Guam | $307.79 | Unavailable |
| Houston | $275.20 | Unavailable |
| Idaho | $254.41 | Unavailable |
| Indiana | $256.16 | Unavailable |
| Iowa | $252.96 | Unavailable |
| Kansas | $250.59 | Unavailable |
| Kentucky | $248.16 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $320.44 | Unavailable |
| Madera | $298.11 | Unavailable |
| Manhattan | $318.72 | Unavailable |
| Merced | $298.11 | Unavailable |
| Metropolitan Boston | $323.81 | Unavailable |
| Metropolitan Kansas City | $260.57 | Unavailable |
| Metropolitan Philadelphia | $286.67 | Unavailable |
| Metropolitan St. Louis | $263.83 | Unavailable |
| Miami | $290.18 | Unavailable |
| Minnesota | $280.53 | Unavailable |
| Mississippi | $240.79 | Unavailable |
| Modesto | $298.11 | Unavailable |
| Montana** | $275.55 | Unavailable |
| Napa | $353.60 | Unavailable |
| Nebraska | $254.86 | Unavailable |
| Nevada** | $275.30 | Unavailable |
| New Hampshire | $285.21 | Unavailable |
| New Mexico | $255.87 | Unavailable |
| New Orleans | $261.54 | Unavailable |
| North Carolina | $258.09 | Unavailable |
| North Dakota** | $273.77 | Unavailable |
| Northern Nj | $316.65 | Unavailable |
| Nyc Suburbs/Long Island | $326.14 | Unavailable |
| Ohio | $254.31 | Unavailable |
| Oklahoma | $248.73 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $319.71 | Unavailable |
| Portland | $302.38 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $300.68 | Unavailable |
| Puerto Rico | $278.20 | Unavailable |
| Queens | $323.18 | Unavailable |
| Redding | $298.11 | Unavailable |
| Rest Of California | $298.11 | Unavailable |
| Rest Of Florida | $266.31 | Unavailable |
| Rest Of Georgia | $249.73 | Unavailable |
| Rest Of Illinois | $255.98 | Unavailable |
| Rest Of Louisiana | $247.31 | Unavailable |
| Rest Of Maine | $254.86 | Unavailable |
| Rest Of Maryland | $278.53 | Unavailable |
| Rest Of Massachusetts | $288.35 | Unavailable |
| Rest Of Michigan | $254.67 | Unavailable |
| Rest Of Missouri | $241.74 | Unavailable |
| Rest Of New Jersey | $299.46 | Unavailable |
| Rest Of New York | $262.44 | Unavailable |
| Rest Of Oregon | $273.69 | Unavailable |
| Rest Of Pennsylvania | $255.34 | Unavailable |
| Rest Of Texas | $262.80 | Unavailable |
| Rest Of Washington | $288.16 | Unavailable |
| Rhode Island | $283.83 | Unavailable |
| Riverside-San Bernardino-Ontario | $299.09 | Unavailable |
| Sacramento-Roseville-Folsom | $315.03 | Unavailable |
| Salinas | $313.91 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $322.94 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $376.84 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $376.74 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $385.32 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $384.90 | Unavailable |
| San Luis Obispo-Paso Robles | $308.62 | Unavailable |
| Santa Cruz-Watsonville | $327.32 | Unavailable |
| Santa Maria-Santa Barbara | $315.53 | Unavailable |
| Santa Rosa-Petaluma | $330.75 | Unavailable |
| Seattle (King Cnty) | $331.91 | Unavailable |
| South Carolina | $256.52 | Unavailable |
| South Dakota** | $273.56 | Unavailable |
| Southern Maine | $272.25 | Unavailable |
| Stockton | $298.11 | Unavailable |
| Suburban Chicago | $284.68 | Unavailable |
| Tennessee | $251.92 | Unavailable |
| Utah | $260.58 | Unavailable |
| Vallejo | $353.45 | Unavailable |
| Vermont | $271.63 | Unavailable |
| Virgin Islands | $278.20 | Unavailable |
| Virginia | $270.52 | Unavailable |
| Visalia | $298.11 | Unavailable |
| West Virginia | $244.82 | Unavailable |
| Wisconsin | $263.21 | Unavailable |
| Wyoming** | $274.78 | Unavailable |
| Yuba City | $298.11 | Unavailable |
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
Swap in your local Medicare rate.
Work 0.84Practice expense 7.32Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| 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
78018-26 · Professional component
$38.08
Pays only the interpretation and report.
78018 compared with similar codes
Compare codes
78018 vs 78016 vs 78015 vs 78020 vs 78014: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78016Thyroid metastasis imaging
- Both involve whole-body thyroid carcinoma metastasis imaging. Choose 78018 when the examination includes additional imaging beyond the whole-body acquisition.
- 78015Thyroid metastasis imaging
- 78015 is for metastasis imaging limited to an area; 78018 is the whole-body option with additional imaging.
- 78020Thyroid uptake
- 78020 is the uptake-focused metastasis service. 78018 reports imaging throughout the body with additional imaging.
- 78014Thyroid scan
- 78014 is thyroid imaging with uptake for evaluating the thyroid; 78018 evaluates thyroid carcinoma metastases with whole-body imaging.
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
Fee sheets
Put 78018 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →