Billing code 78020: Thyroid uptakeMedicare rate & RVUs in Illinois
Reports quantitative whole-body radioactive iodine uptake measurement for thyroid carcinoma, as an add-on to the related whole-body metastasis imaging service.
Medicare pays $74.86–$81.90 for 78020 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
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 9 sections
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.
Where 78020 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$74.86 to $81.90
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $81.32 | Unavailable |
| East St. Louis | $75.87 | Unavailable |
| Rest Of Illinois | $74.86 | Unavailable |
| Suburban Chicago | $81.90 | Unavailable |
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
Swap in your local Medicare rate.
Work 0.59Practice expense 1.74Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78020
The CMS indicators that decide how 78020 is paid alongside other services.
CMS payment indicators · 78020
Thyroid uptake
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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
78020 without 26 · national office
$79.16
Thyroid uptake
78020-26 · Professional component
$26.05
Pays only the interpretation and report.
78020 compared with similar codes
Compare codes
78020 vs 78018 vs 78015 vs 78012: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78018Thyroid metastasis scan
- 78018 is the primary whole-body thyroid carcinoma metastasis imaging service. Add 78020 when quantitative whole-body uptake measurement is also performed.
- 78015Thyroid metastasis imaging
- 78015 addresses thyroid carcinoma metastasis imaging of a limited area. 78020 is for quantitative whole-body uptake measurement and requires its primary procedure.
- 78012Thyroid uptake
- 78012 measures thyroid uptake for a different thyroid evaluation; 78020 quantifies whole-body uptake in the thyroid carcinoma metastasis imaging context.
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
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