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CMS RVU26D · Effective 2026-10-01

78606 Brain imaging Medicare reimbursement rates in Virginia

Reports a nuclear medicine brain study that includes blood-flow imaging and four or more views for assessment of cerebral perfusion. Compare 78606 office and facility rates across CMS payment localities in Virginia.

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 78606 in Virginia?

Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$282.63–$336.42

2 of 2 localities have a supported rate.

Lowest: Virginia

Highest: Dc + Md/Va Suburbs

A spread of $53.79 per service.

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 78606 in your payment locality →

Nuclear medicine

About 78606: Brain nuclear imaging with flow, four or more views

Reports a nuclear medicine brain study that includes blood-flow imaging and four or more views for assessment of cerebral perfusion.

This service combines imaging of blood flow to the brain with multiple brain images. A radiopharmaceutical is administered and imaging is acquired to show the flow phase and the brain in four or more views. Nuclear medicine physicians and radiologists commonly interpret these studies in hospital or imaging-center settings when the requested examination calls for both flow information and multi-view brain imaging.

Select this code when the documented study includes flow imaging and at least four views; the number of views and the flow component distinguish it from nearby brain-scan codes. The report should support the performed phases and views, and the interpretation should address the findings. Medicare recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and an unmodified claim represents the global service. The CMS facts identify both modifiers as separately priced.

CMS billing rules for 78606

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 RVU0.62 · 7%
  • Practice expense (office) RVU7.92 · 92%
  • Malpractice RVU0.08 · 1%

187

Medicare services in 2024 · #4378 by national volume

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.

78606 compared with similar codes

Office rates for Virginia, from the same CMS release.

78605

Brain imaging

Four or more views

$175.96–$208.98

Choose 78606 when the study includes flow imaging as well as four or more views. Choose 78605 for four or more views without flow imaging.

78601

Brain imaging

With flow, fewer than four views

$189.08–$224.81

Both include flow imaging, but 78601 is for fewer than four views; 78606 is for four or more.

78610

Brain flow scan

Flow acquisition only

$153.60–$183.20

78610 covers flow imaging alone. Use 78606 when the study also acquires four or more brain views.

78608

Brain imaging (pet)

No office rate

78608 describes brain imaging by PET. 78606 is the multi-view brain study that includes flow imaging.

Compare 78606 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.

2 of 2 payment localities

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

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78606 billing questions

How does 78606 differ from 78605?

78606 includes flow imaging as well as four or more brain views. 78605 describes the four-or-more-view study without the flow component.

When is 78601 a better fit?

Use 78601 when the brain study includes flow imaging but has fewer than four views. The documented view count separates it from 78606.

What do modifiers 26 and TC represent?

Modifier 26 reports the professional interpretation, while TC reports the technical service, including equipment and staff. Without either modifier, the claim represents the global service.

What should the report document to support 78606?

The record should show that flow imaging was performed and document four or more brain views. The interpretation should correspond to the acquired study.

Can 78610 be reported instead?

78610 is for brain flow imaging alone. Choose 78606 when the examination also includes four or more brain views.

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 78606PPRRVU2026_Oct_nonQPP.csv, line 9,452 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet