Billing code 78016: Thyroid metastasis imagingMedicare rate & RVUs in Oregon
Reports whole-body nuclear imaging to evaluate thyroid carcinoma for metastatic disease, such as iodine-avid spread beyond the thyroid bed.
Medicare pays $249.92–$276.03 for 78016 in the office in Oregon, from Rest Of Oregon to Portland. 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 78016 covers
This study images the body for metastatic thyroid carcinoma after administration of a thyroid-seeking radiopharmaceutical. It is commonly used in the evaluation or follow-up of differentiated thyroid cancer, including searches for iodine-avid disease outside the thyroid bed. Nuclear medicine staff perform the imaging, and a nuclear medicine physician or radiologist interprets the findings. The whole-body extent distinguishes this service from limited-area thyroid cancer metastasis imaging.
Report 78016 when the documented study covers the whole body for metastatic thyroid carcinoma. The record should identify the clinical indication and support the extent and interpretation of the imaging performed. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff service, and billing without either modifier represents the global service. The professional and technical portions may be billed separately by the respective providers when applicable.
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 78016 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $276.03 | Unavailable |
| Rest Of Oregon | $249.92 | Unavailable |
How the 78016 rate is calculated
Each of 78016’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 · 78016
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.80Practice expense 6.66Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78016
The CMS indicators that decide how 78016 is paid alongside other services.
CMS payment indicators · 78016
Thyroid metastasis imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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
78016 without 26 · national office
$251.51
Thyroid metastasis imaging
78016-26 · Professional component
$32.06
Pays only the interpretation and report.
78016 compared with similar codes
Compare codes
78016 vs 78015 vs 78018 vs 78020 vs 78014: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78015Thyroid metastasis imaging
- Choose 78016 for whole-body metastasis imaging and 78015 when imaging is limited to an area.
- 78018Thyroid metastasis scan
- 78018 is the related whole-body study with additional views; 78016 describes whole-body imaging without that distinction.
- 78020Thyroid uptake
- 78020 describes quantitative uptake assessment for thyroid carcinoma metastases, not whole-body imaging.
- 78014Thyroid scan
- 78014 is thyroid imaging with uptake for thyroid evaluation; 78016 is whole-body imaging directed at thyroid carcinoma metastases.
78016 billing questions
How does 78016 differ from 78015?
78016 is for whole-body imaging to evaluate thyroid carcinoma metastases. 78015 is used when the metastasis imaging is limited to an area.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
What documentation supports 78016?
Document the thyroid carcinoma indication, the whole-body imaging performed, and the interpreting clinician’s findings. The record should support that the study evaluated metastatic disease.
Is 78016 the same as thyroid uptake measurement?
No. 78016 describes whole-body imaging for thyroid carcinoma metastases; 78012 is for thyroid uptake measurement. Select the code for the service actually performed.
How does 78016 differ from 78018?
Both are in the thyroid carcinoma metastasis imaging family. 78018 describes whole-body imaging with additional views, while 78016 represents whole-body imaging.
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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