Billing code 78018: Thyroid metastasis scanMedicare rate & RVUs in Ohio

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.

CMS RVU26DEffective Oct 1, 20261 payment locality4K Medicare services in 2024

Medicare pays $254.31 for 78018 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$254.31Office (non-facility)
—Hospital or facility

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

We’ll open 78018 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 78018 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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.

78018 in Ohio

78018 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$254.31Unavailable

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

Work0.84

0.84 RVUs× 1.000 GPCI

Practice expense7.32

7.32 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

8.2500

Conversion factor

$33.4009

Medicare rate

$275.56

Every GPCI starts 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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

78018 compared with similar codes

Compare codes · National

5 codes, side by side

  • 78018

    Thyroid metastasis scan0.84 wRVU

    $275.56

  • 78016

    Thyroid metastasis imaging0.8 wRVU

    $251.51−$24.05

  • 78015

    Thyroid metastasis imaging0.65 wRVU

    $204.08−$71.48

  • 78020

    Thyroid uptake0.59 wRVU

    $79.16−$196.40

  • 78014

    Thyroid scan0.49 wRVU

    $210.76−$64.80

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
RVUs for 78018PPRRVU2026_Oct_nonQPP.csv, line 9,194 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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