Billing code 78601: Brain imagingMedicare rate & RVUs in Virginia
Reports nuclear medicine brain imaging that includes a vascular-flow phase and fewer than four views for evaluation of cerebral tracer distribution.
Medicare pays $189.08–$224.81 for 78601 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 78601 covers
This nuclear medicine service combines imaging of tracer movement through the brain’s blood supply with images of tracer distribution in the brain. It is performed in a nuclear medicine department, commonly in a hospital setting, by technologists who acquire the study for interpretation by a qualified physician. The documented study includes fewer than four views; dynamic frames during the flow phase are not a substitute for the view count used to distinguish this service from higher-view codes.
Select the code when the performed study includes both flow imaging and brain imaging, and the recorded views meet this code’s range. The report should identify the flow and imaging portions and document the acquired views. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents 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.
Where 78601 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $224.81 | Unavailable |
| Virginia | $189.08 | Unavailable |
How the 78601 rate is calculated
Each of 78601’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 · 78601
RVUs × geographic indexes × conversion factor
Work0.50
0.50 RVUs× 1.000 GPCI
Practice expense5.20
5.20 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
5.7700
Conversion factor
$33.4009
Medicare rate
$192.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78601
The CMS indicators that decide how 78601 is paid alongside other services.
CMS payment indicators · 78601
Brain 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
78601 without 26 · national office
$192.72
Brain imaging
78601-26 · Professional component
$23.38
Pays only the interpretation and report.
78601 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78600Brain imaging
- Choose 78600 when brain imaging is performed without a vascular-flow phase. Choose 78601 when the examination includes flow imaging as well.
- 78605Brain imaging
- 78605 is for brain imaging without flow imaging when four or more views are documented; 78601 includes flow imaging and fewer than four views.
- 78606Brain imaging
- Both codes include flow imaging, but 78606 is for four or more views. 78601 is for fewer than four.
- 78610Brain flow scan
- 78610 covers flow imaging alone. 78601 includes both the flow phase and brain imaging.
78601 billing questions
How does this differ from 78600?
78601 includes a vascular-flow imaging phase along with brain imaging. 78600 describes brain imaging without that flow component.
When should 78605 or 78606 be selected instead?
Use the four-or-more-view code when the study documents at least four views. 78605 is without flow imaging; 78606 includes flow imaging.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 reports the physician’s interpretation, and modifier TC reports the technical service. Without either modifier, the claim represents the global service.
Is 78610 interchangeable with this code?
No. 78610 is for brain flow imaging alone; 78601 includes brain imaging in addition to the flow phase.
What documentation supports reporting 78601?
Document that the examination included both a flow phase and brain imaging, and record the number of views acquired. The report should support the interpretation billed with modifier 26.
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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