Billing code 78630: CSF scanMedicare rate & RVUs

Medicare pays $294.60 for 78630 nationally in the office. Local office rates run $255.02–$414.46.

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

What 78630 covers

This nuclear medicine study follows a radiotracer through cerebrospinal fluid spaces after intrathecal administration, with images obtained to evaluate CSF circulation and distribution. It is typically performed in a hospital nuclear medicine department or imaging center, with a nuclear medicine physician or radiologist interpreting the study. A clinician may request it when the diagnostic question concerns how CSF moves through the intracranial spaces rather than brain tissue appearance or shunt function alone.

Report 78630 for the CSF scan itself; the medical record should support the clinical question, the study performed, and the interpreting physician’s findings. CMS recognizes professional and technical components: report modifier 26 for the interpretation, TC for the equipment and staff, or neither modifier when billing the global service. The professional and technical services may be billed separately when performed by different entities. The scan’s findings should be distinguished from a targeted CSF leak study, ventricular study, or shunt evaluation when selecting among related nuclear medicine services.

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 78630 pays more and less

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

109 of 109 payment localities

78630 rates by state

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

How the 78630 rate is calculated

Each of 78630’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.

Payment rules and modifiers for 78630

The CMS indicators that decide how 78630 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78630 compared with similar codes

How to choose

78635CSF imaging

78630 assesses tracer movement through CSF spaces; 78635 is the ventricular-focused CSF study.

78645CSF shunt study

Use 78645 when the study evaluates a CSF shunt. Code 78630 for a scan addressing CSF circulation and distribution.

78650CSF leak imaging

78650 is directed at CSF leakage imaging; 78630 describes the broader CSF scan.

Codes related to 78630

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

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

Open CMS sourceHow we calculate rates