Billing code 78013: Thyroid imagingMedicare rate & RVUs in Washington
Reports nuclear medicine imaging of the thyroid that includes blood-flow assessment, used to evaluate thyroid tissue distribution and suspected functional abnormalities.
Medicare pays $173.83–$200.87 for 78013 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 78013 covers
A nuclear medicine study captures images of the thyroid and includes a blood-flow phase. It can help evaluate the distribution of functioning thyroid tissue, including suspected autonomous tissue or ectopic thyroid tissue. A nuclear medicine physician or radiologist typically interprets the images after acquisition with a gamma camera in a hospital or imaging center.
Report 78013 when the service includes thyroid imaging with blood-flow assessment but does not include quantitative thyroid uptake measurement. The record should support the clinical reason for imaging and document the performed imaging protocol and interpretation. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Without either modifier, the claim 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 78013 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $173.83 | Unavailable |
| Seattle (King Cnty) | $200.87 | Unavailable |
How the 78013 rate is calculated
Each of 78013’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 · 78013
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.36Practice expense 4.56Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78013
The CMS indicators that decide how 78013 is paid alongside other services.
CMS payment indicators · 78013
Thyroid 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
78013 without 26 · national office
$166.00
Thyroid imaging
78013-26 · Professional component
$16.70
Pays only the interpretation and report.
78013 compared with similar codes
Compare codes
78013 vs 78014 vs 78012 vs 78015: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78014Thyroid scan
- 78014 includes thyroid uptake measurement with the imaging; 78013 represents imaging with blood-flow assessment without that uptake measurement.
- 78012Thyroid uptake
- 78012 reports quantitative thyroid uptake measurement alone. Choose 78013 when thyroid imaging with blood-flow assessment is performed instead.
- 78015Thyroid metastasis imaging
- 78015 is directed at imaging thyroid carcinoma metastases in a limited area, not imaging the thyroid gland with blood-flow assessment.
78013 billing questions
How does 78013 differ from 78014?
78013 represents thyroid imaging with blood-flow assessment. Use 78014 when the imaging service also includes one or more quantitative thyroid uptake measurements.
When should 78012 be considered instead?
78012 is for quantitative thyroid uptake measurement without the thyroid imaging service represented by 78013. Choose based on the service actually performed and documented.
When are modifiers 26 and TC appropriate?
Use modifier 26 for the physician's interpretation and modifier TC for the technical service, including equipment and staff. Billing without either modifier represents the global service.
What documentation supports reporting 78013?
Document the clinical reason for the thyroid study, the imaging performed including its blood-flow phase, and the physician's interpretation. The record should distinguish imaging from any separately performed uptake measurement.
Is 78013 the code for thyroid cancer metastasis imaging?
No. 78013 describes thyroid imaging with blood-flow assessment; 78015 is for imaging directed at thyroid carcinoma metastases in a limited area.
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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