CPT 78601
Global XXX ActiveBrain image w/flow < 4 views
CPT 78601 Billing & Documentation Guide
CPT code 78601 (Brain image w/flow < 4 views) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.5, a non-facility practice expense RVU of 5.2, and a malpractice RVU of 0.07, a total non-facility RVU of 5.77 and facility RVU of 5.77. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $200.31, though rates vary from $167.1 to $270.24 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78601, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 78601 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 78601 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 78601
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.5 | 0.5 |
| Practice Expense RVU | 5.2 | 5.2 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 5.77 | 5.77 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78601
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $224.09 | $224.09 | $208.6 - $270.24 | 29 |
| Florida | $195.52 | $195.52 | $186.26 - $203.42 | 3 |
| Georgia | $185.22 | $185.22 | $174.41 - $196.02 | 2 |
| Illinois | $189.05 | $189.05 | $178.93 - $199.33 | 4 |
| Michigan | $183.08 | $183.08 | $177.91 - $188.25 | 2 |
| North Carolina | $180.24 | $180.24 | $180.24 - $180.24 | 1 |
| New York | $214.43 | $214.43 | $183.34 - $228.62 | 5 |
| Ohio | $177.63 | $177.63 | $177.63 - $177.63 | 1 |
| Pennsylvania | $189.48 | $189.48 | $178.35 - $200.6 | 2 |
| Texas | $189.96 | $189.96 | $176.93 - $202.56 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 78601
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78601 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0394T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0395T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 78601
What does CPT code 78601 mean? +
CPT code 78601 represents: Brain image w/flow < 4 views. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78601? +
The 2026 Medicare national average non-facility payment for CPT 78601 is $200.31. Rates range from $167.1 to $270.24 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78601? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 78601? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 17, 2026.
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