Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Nervous SystemCPT cpt-78605-brain-nuclear-static-imaging-four-or-more-views
    Ask Trek AI about this page

    CPT 78605: Brain Nuclear Diagnostic Imaging, Four+ Static Views

    Medicare pays $125 on average nationally for this procedure.

    CPT code 78605 describes nuclear diagnostic imaging of the brain using a radiopharmaceutical to evaluate brain function, performed as four or more static (two-dimensional) views; service type: nuclear medicine imaging, typical site of service: hospital outpatient imaging department or standalone nuclear medicine clinic.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

    Customize your policy alerts

    Sign up for cpt 78605 policy alerts

    Get alerted when payer policies referencing 78605 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 68-year-old man referred by neurology for evaluation of suspected cerebrovascular disease after transient episodes of confusion and focal weakness. The clinician orders a nuclear medicine brain perfusion study to assess regional cerebral blood flow. The patient arrives at the outpatient radiology/nuclear medicine department or an inpatient hospital imaging suite. After verification of identity, indication, and contrast/allergy history, an intravenous line is placed and a radiopharmaceutical (commonly Tc-99m HMPAO or Tc-99m ECD) is administered. The technologist acquires four or more static two-dimensional views of the brain according to protocol while the patient remains still. Images are processed and preliminary quality checks are performed by the technologist; the nuclear medicine physician (radiologist or nuclear medicine specialist) reviews, interprets, and documents findings in the medical record, including relevant comparisons to prior imaging. The study supports diagnoses such as cerebrovascular insufficiency, occlusive disease, stroke localization, or evaluation of suspected cerebral death or encephalopathy, and results are communicated to the referring clinician for further management. Typical sites of service are outpatient imaging centers, hospital radiology or nuclear medicine departments, and inpatient hospital imaging units.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78591Myocardial perfusion imaging, planar, SPECT or PET, single study — single dayNot directly related to brain imaging; included when cardiac and brain nuclear studies are part of multisystem evaluation (use clinical discretion).
    78830Positron emission tomography (PET) imaging, brain, metabolic evaluationAlternative nuclear modality for brain metabolic evaluation; may be ordered when PET provides superior diagnostic information.
    70553Magnetic resonance imaging, brain, with and without contrastCross-sectional anatomic imaging often performed before or after nuclear studies for structural correlation.
    94620Pulmonary stress imaging (ventilation-perfusion)Unrelated service; included only when multiple nuclear studies are performed during same encounter.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RR0500X
    174400000X
    2084F0202X
    174200000X
    2088F0040X
    225XE1200X
    246YC3301X
    2084N0400X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
    F07.81Postconcussional syndrome
    G30.9Alzheimer's disease, unspecified
    G31.84Mild cognitive impairment of uncertain or unknown etiology
    G40.901Epilepsy, unspecified, not intractable, with status epilepticus
    G40.909Epilepsy, unspecified, not intractable, without status epilepticus
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    G45.9Transient cerebral ischemic attack, unspecified
    G93.1Anoxic brain damage, not elsewhere classified

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-78600-BRAIN-NUCLEAR-STATIC-IMAGING-FEWER-THAN-FOUR-VIEWS

    CPT 78600: Nuclear Diagnostic Brain Imaging, <4 Static Views

    CPT-78601-BRAIN-NUCLEAR-PERFUSION-IMAGING-FEWER-THAN-FOUR-STATIC-VIEWS

    CPT 78601: Nuclear Diagnostic Brain Imaging, Static Views and Flow

    CPT-78606-NUCLEAR-BRAIN-IMAGING-STATIC-VIEWS-CEREBRAL-BLOOD-FLOW

    CPT 78606: Brain Nuclear Imaging, Static Views with Flow Evaluation

    CPT-78608-PET-BRAIN-METABOLIC-IMAGING

    CPT 78608: Brain PET for Cerebral Metabolic Imaging

    CPT-78609-PET-BRAIN-IMAGING

    CPT 78609: Brain PET Scan for Function and Perfusion

    CPT-78610-CEREBRAL-PERFUSION-NUCLEAR-MEDICINE-STUDY

    CPT 78610: Brain Perfusion Study with Gamma Tracer

    CPT-78630-CSF-FLOW-STUDY-HYDROCEPHALUS-LEAK-EVALUATION

    CPT 78630: Cerebrospinal Fluid (CSF) Flow Study, Head

    CPT-78635-CSF-FLOW-VENTRICULAR-IMAGING-HYDROCEPHALUS

    CPT 78635: CSF Flow Study for Ventricular Assessment

    CPT-78645-CSF-SHUNT-FLOW-IMAGING

    CPT 78645: CSF Shunt Patency and Flow Imaging Study

    CPT-78650-CSF-LEAK-NUCLEAR-IMAGING-LOCALIZATION

    CPT 78650: Nuclear Medicine Localization of CSF Leak

    Showing 1–10 of 12

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.