$155.72–$250.76
Choose 78606 when the study includes flow imaging as well as four or more views. Choose 78605 for four or more views without flow imaging.
On this page
CMS RVU26D · Effective 2026-10-01
78606 Brain imaging Medicare reimbursement rates
Reports a nuclear medicine brain study that includes blood-flow imaging and four or more views for assessment of cerebral perfusion. Compare 78606 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 78606?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$249.32–$405.88
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $156.56 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 78606 pays more and less
109 payment localities
$249.32 to $405.88
Nuclear medicine
About 78606: Brain nuclear imaging with flow, four or more views
Reports a nuclear medicine brain study that includes blood-flow imaging and four or more views for assessment of cerebral perfusion.
This service combines imaging of blood flow to the brain with multiple brain images. A radiopharmaceutical is administered and imaging is acquired to show the flow phase and the brain in four or more views. Nuclear medicine physicians and radiologists commonly interpret these studies in hospital or imaging-center settings when the requested examination calls for both flow information and multi-view brain imaging.
Select this code when the documented study includes flow imaging and at least four views; the number of views and the flow component distinguish it from nearby brain-scan codes. The report should support the performed phases and views, and the interpretation should address the findings. Medicare recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and an unmodified claim represents the global service. The CMS facts identify both modifiers as separately priced.
CMS billing rules for 78606
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.62 · 7%
- Practice expense (office) RVU7.92 · 92%
- Malpractice RVU0.08 · 1%
187
Medicare services in 2024 · #4378 by national volume
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.
78606 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$167.10–$270.24
Both include flow imaging, but 78601 is for fewer than four views; 78606 is for four or more.
$135.24–$220.86
78610 covers flow imaging alone. Use 78606 when the study also acquires four or more brain views.
78608
No office rateBrain imaging (pet)
78608 describes brain imaging by PET. 78606 is the multi-view brain study that includes flow imaging.
See how rates vary across the country
78606 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$249.32
$359.15
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $314.27 | 1 |
| AL | $253.69 | 1 |
| AR | $249.32 | 1 |
| AZ | $279.33 | 1 |
| CA | $312.42–$405.88 | 29 |
| CO | $304.51 | 1 |
| CT | $309.26 | 1 |
| DC | $336.42 | 1 |
| DE | $284.57 | 1 |
| FL | $277.62–$302.85 | 3 |
| GA | $259.86–$292.75 | 2 |
| GU | $323.03 | 1 |
| HI | $323.03 | 1 |
| IA | $263.82 | 1 |
| ID | $265.34 | 1 |
| IL | $266.41–$297.27 | 4 |
| IN | $267.23 | 1 |
| KS | $261.20 | 1 |
| KY | $258.33 | 1 |
| LA | $257.38–$272.67 | 2 |
| MA | $301.73–$339.79 | 2 |
| MD | $291.08–$336.42 | 3 |
| ME | $265.74–$284.55 | 2 |
| MI | $265.25–$280.49 | 2 |
| MN | $293.71 | 1 |
| MO | $251.34–$275.22 | 3 |
| MS | $250.45 | 1 |
| MT | $287.91 | 1 |
| NC | $269.23 | 1 |
| ND | $286.33 | 1 |
| NE | $265.88 | 1 |
| NH | $298.43 | 1 |
| NJ | $313.34–$331.73 | 2 |
| NM | $266.50 | 1 |
| NV | $287.73 | 1 |
| NY | $273.90–$341.53 | 5 |
| OH | $264.92 | 1 |
| OK | $259.01 | 1 |
| OR | $286.06–$316.93 | 2 |
| PA | $266.08–$299.65 | 2 |
| PR | $290.79 | 1 |
| RI | $296.75 | 1 |
| SC | $267.41 | 1 |
| SD | $286.14 | 1 |
| TN | $262.61 | 1 |
| TX | $263.92–$303.00 | 8 |
| UT | $271.77 | 1 |
| VA | $282.63–$336.42 | 2 |
| VI | $290.79 | 1 |
| VT | $283.95 | 1 |
| WA | $301.57–$348.51 | 2 |
| WI | $274.96 | 1 |
| WV | $254.41 | 1 |
| WY | $287.22 | 1 |
Compare 78606 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $253.69 | Facility Unavailable |
| Alaska* | Office $314.27 | Facility Unavailable |
| Arizona | Office $279.33 | Facility Unavailable |
| Arkansas | Office $249.32 | Facility Unavailable |
| Atlanta | Office $292.75 | Facility Unavailable |
| Austin | Office $303.00 | Facility Unavailable |
| Bakersfield | Office $312.66 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $308.19 | Facility Unavailable |
| Beaumont | Office $263.92 | Facility Unavailable |
| Brazoria | Office $285.11 | Facility Unavailable |
| Chicago | Office $292.84 | Facility Unavailable |
| Chico | Office $312.42 | Facility Unavailable |
| Colorado | Office $304.51 | Facility Unavailable |
| Connecticut | Office $309.26 | Facility Unavailable |
| Dallas | Office $286.66 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $336.42 | Facility Unavailable |
| Delaware | Office $284.57 | Facility Unavailable |
| Detroit | Office $280.49 | Facility Unavailable |
| East St. Louis | Office $269.46 | Facility Unavailable |
| El Centro | Office $312.44 | Facility Unavailable |
| Fort Lauderdale | Office $293.51 | Facility Unavailable |
| Fort Worth | Office $284.05 | Facility Unavailable |
| Fresno | Office $312.42 | Facility Unavailable |
| Galveston | Office $285.77 | Facility Unavailable |
| Hanford-Corcoran | Office $312.42 | Facility Unavailable |
| Hawaii, Guam | Office $323.03 | Facility Unavailable |
| Houston | Office $287.23 | Facility Unavailable |
| Idaho | Office $265.34 | Facility Unavailable |
| Indiana | Office $267.23 | Facility Unavailable |
| Iowa | Office $263.82 | Facility Unavailable |
| Kansas | Office $261.20 | Facility Unavailable |
| Kentucky | Office $258.33 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $336.28 | Facility Unavailable |
| Madera | Office $312.42 | Facility Unavailable |
| Manhattan | Office $333.66 | Facility Unavailable |
| Merced | Office $312.42 | Facility Unavailable |
| Metropolitan Boston | Office $339.79 | Facility Unavailable |
| Metropolitan Kansas City | Office $271.72 | Facility Unavailable |
| Metropolitan Philadelphia | Office $299.65 | Facility Unavailable |
| Metropolitan St. Louis | Office $275.22 | Facility Unavailable |
| Miami | Office $302.85 | Facility Unavailable |
| Minnesota | Office $293.71 | Facility Unavailable |
| Mississippi | Office $250.45 | Facility Unavailable |
| Modesto | Office $312.42 | Facility Unavailable |
| Montana** | Office $287.91 | Facility Unavailable |
| Napa | Office $372.03 | Facility Unavailable |
| Nebraska | Office $265.88 | Facility Unavailable |
| Nevada** | Office $287.73 | Facility Unavailable |
| New Hampshire | Office $298.43 | Facility Unavailable |
| New Mexico | Office $266.50 | Facility Unavailable |
| New Orleans | Office $272.67 | Facility Unavailable |
| North Carolina | Office $269.23 | Facility Unavailable |
| North Dakota** | Office $286.33 | Facility Unavailable |
| Northern Nj | Office $331.73 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $341.53 | Facility Unavailable |
| Ohio | Office $264.92 | Facility Unavailable |
| Oklahoma | Office $259.01 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $335.63 | Facility Unavailable |
| Portland | Office $316.93 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $314.54 | Facility Unavailable |
| Puerto Rico | Office $290.79 | Facility Unavailable |
| Queens | Office $338.57 | Facility Unavailable |
| Redding | Office $312.42 | Facility Unavailable |
| Rest Of California | Office $312.42 | Facility Unavailable |
| Rest Of Florida | Office $277.62 | Facility Unavailable |
| Rest Of Georgia | Office $259.86 | Facility Unavailable |
| Rest Of Illinois | Office $266.41 | Facility Unavailable |
| Rest Of Louisiana | Office $257.38 | Facility Unavailable |
| Rest Of Maine | Office $265.74 | Facility Unavailable |
| Rest Of Maryland | Office $291.08 | Facility Unavailable |
| Rest Of Massachusetts | Office $301.73 | Facility Unavailable |
| Rest Of Michigan | Office $265.25 | Facility Unavailable |
| Rest Of Missouri | Office $251.34 | Facility Unavailable |
| Rest Of New Jersey | Office $313.34 | Facility Unavailable |
| Rest Of New York | Office $273.90 | Facility Unavailable |
| Rest Of Oregon | Office $286.06 | Facility Unavailable |
| Rest Of Pennsylvania | Office $266.08 | Facility Unavailable |
| Rest Of Texas | Office $274.17 | Facility Unavailable |
| Rest Of Washington | Office $301.57 | Facility Unavailable |
| Rhode Island | Office $296.75 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $313.29 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $330.54 | Facility Unavailable |
| Salinas | Office $329.38 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $339.16 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $396.90 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $396.81 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $405.88 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $405.51 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $323.80 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $343.99 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $331.17 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $347.61 | Facility Unavailable |
| Seattle (King Cnty) | Office $348.51 | Facility Unavailable |
| South Carolina | Office $267.41 | Facility Unavailable |
| South Dakota** | Office $286.14 | Facility Unavailable |
| Southern Maine | Office $284.55 | Facility Unavailable |
| Stockton | Office $312.42 | Facility Unavailable |
| Suburban Chicago | Office $297.27 | Facility Unavailable |
| Tennessee | Office $262.61 | Facility Unavailable |
| Utah | Office $271.77 | Facility Unavailable |
| Vallejo | Office $371.90 | Facility Unavailable |
| Vermont | Office $283.95 | Facility Unavailable |
| Virgin Islands | Office $290.79 | Facility Unavailable |
| Virginia | Office $282.63 | Facility Unavailable |
| Visalia | Office $312.42 | Facility Unavailable |
| West Virginia | Office $254.41 | Facility Unavailable |
| Wisconsin | Office $274.96 | Facility Unavailable |
| Wyoming** | Office $287.22 | Facility Unavailable |
| Yuba City | Office $312.42 | Facility Unavailable |
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78606 billing questions
How does 78606 differ from 78605?
78606 includes flow imaging as well as four or more brain views. 78605 describes the four-or-more-view study without the flow component.
When is 78601 a better fit?
Use 78601 when the brain study includes flow imaging but has fewer than four views. The documented view count separates it from 78606.
What do modifiers 26 and TC represent?
Modifier 26 reports the professional interpretation, while TC reports the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What should the report document to support 78606?
The record should show that flow imaging was performed and document four or more brain views. The interpretation should correspond to the acquired study.
Can 78610 be reported instead?
78610 is for brain flow imaging alone. Choose 78606 when the examination also includes four or more brain views.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
9,44978605,,Brain image 4+ views,A,,0.52,4.78,,4.78,NA,0.07,5.37,5.37,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.65,16.65,0.17
9,45078605,26,Brain image 4+ views,A,,0.52,0.19,,0.19,,0.03,0.74,0.74,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,45178605,TC,Brain image 4+ views,A,,0.00,4.59,,4.59,NA,0.04,4.63,4.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.46,16.46,0.14
9,45278606,,Brain image w/flow 4 + views,A,,0.62,7.92,,7.92,NA,0.08,8.62,8.62,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.71,16.71,0.14
9,45378606,26,Brain image w/flow 4 + views,A,,0.62,0.21,,0.21,,0.03,0.86,0.86,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,45478606,TC,Brain image w/flow 4 + views,A,,0.00,7.71,,7.71,NA,0.05,7.76,7.76,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.50,16.50,0.11
9,45578608,,Brain imaging (pet),C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,44.20,44.20,0.08