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CMS RVU26D · Effective 2026-10-01

78635 CSF imaging Medicare reimbursement rates in Indiana

Nuclear imaging tracks radiotracer movement through ventricular cerebrospinal fluid when clinicians need to assess flow within the brain’s ventricular system. Compare 78635 office and facility rates across CMS payment localities in Indiana.

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 78635 in Indiana?

Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

$273.35

1 of 1 localities have a supported rate.

Payment area: Indiana

One mapped payment locality.

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.

Find 78635 in your payment locality →

Nuclear medicine

About 78635: Cerebrospinal fluid ventriculography

Nuclear imaging tracks radiotracer movement through ventricular cerebrospinal fluid when clinicians need to assess flow within the brain’s ventricular system.

This nuclear medicine study follows radiotracer distribution through cerebrospinal fluid in the ventricular system. It is used when clinicians need information about ventricular CSF flow, such as in evaluating a suspected flow abnormality. A nuclear medicine physician interprets the images; the study may involve ventricular access for tracer administration, with imaging performed in a nuclear medicine department.

Report 78635 for the ventricular CSF imaging service, rather than a general brain scan or a study focused on shunt function or CSF leakage. The record should support the clinical question, tracer administration and access route, images obtained, and the physician’s interpretation. CMS recognizes a professional component, reported with modifier 26 for interpretation, and a technical component, reported with modifier TC for equipment and staff. Without either modifier, the claim represents the global service.

CMS billing rules for 78635

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 RVU0.59 · 7%
  • Practice expense (office) RVU8.15 · 92%
  • Malpractice RVU0.08 · 1%

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.

78635 compared with similar codes

Office rates for Indiana, from the same CMS release.

78630

CSF scan

Cisternography

$273.23

Choose 78635 for imaging focused on ventricular CSF flow. Code 78630 describes a CSF scan using a different approach to assess CSF circulation.

78645

CSF shunt study

Shunt patency assessment

$264.61

Use 78645 when the study evaluates a CSF shunt. Use 78635 for ventricular CSF imaging when shunt function is not the specific study target.

78650

CSF leak imaging

Leak detection and localization

$227.67

Code 78650 is for imaging directed at a suspected CSF leak; 78635 focuses on CSF movement through the ventricles.

Compare 78635 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

  • Indiana →

    Office / nonfacility

    $273.35

    Facility

    Unavailable

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 78635 in Indiana.

PPRRVU2026_Oct_nonQPP.csv

9,467

Code
78635
Physician work
0.59
Practice expense
8.15
Malpractice
0.08

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Office / nonfacility calculation for 78635 in Indiana
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense8.15× 0.9277.5551
Malpractice0.08× 0.4860.0389
Total RVUs8.1839
Conversion factor× 33.4009

Office / nonfacility rate, Indiana$273.35

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.591
Practice expense8.150.927
Malpractice0.080.486

(0.59 × 1 + 8.15 × 0.927 + 0.08 × 0.486) × $33.4009 = $273.35

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

78635 billing questions

How does 78635 differ from a CSF scan?

78635 describes imaging focused on CSF movement through the ventricular system. A CSF scan such as 78630 is used for a different CSF imaging approach and clinical question.

When should 78645 be considered instead?

Use 78645 when the study evaluates CSF shunt function. Code 78635 describes ventricular CSF imaging, not a shunt-specific evaluation.

Can the professional and technical portions be billed separately?

Yes. Report modifier 26 for the physician’s interpretation or TC for the technical service, which includes equipment and staff. Billing without a modifier represents the global service.

What documentation supports reporting 78635?

Document the reason for evaluating ventricular CSF flow, the tracer administration and access route, the imaging performed, and the interpreting physician’s findings.

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.

RVUs for 78635PPRRVU2026_Oct_nonQPP.csv, line 9,467 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet