CPT code 78579: Lung scan, ventilation only2026 Medicare rate & RVUs in Merced, CA

Reports nuclear medicine imaging of inhaled tracer distribution in the lungs, commonly as the ventilation portion of an evaluation for suspected pulmonary embolism.

CMS RVU26DEffective Oct 1, 2026One payment locality205 Medicare services in 2024

In Merced, CA, Medicare pays $179.92 for 78579 in the office.

$179.92Office (non-facility)
Not available in this settingHospital or facility
+8.2%vs the national office rate ($166.34)

Check a contract rate as a % of Medicare · 78579 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 78579 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Merced, CA
  2. What 78579 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 78579 covers

A lung ventilation study uses inhaled radioactive gas or aerosol to show how air and tracer distribute through the lungs. A nuclear medicine technologist typically acquires the images in a hospital or imaging department, with a radiologist or nuclear medicine physician interpreting them. The study is often part of an evaluation for suspected pulmonary embolism, where ventilation findings may be considered alongside lung perfusion imaging.

Report this code when the service performed is ventilation imaging, rather than a combined ventilation-and-perfusion study. The record should support the ventilation procedure performed and the resulting interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither modifier for the global service. These components are separately priced in the Medicare fee schedule.

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.

How Merced, CA compares for 78579

Across 109 of 109 payment localities, the office rate for 78579 runs from $144.45 in Arkansas to $232.72 in San Benito County, CA. Merced, CA pays $179.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

78579 in Merced, CA vs other payment areas
  1. Merced, CA · this page$179.92
  2. Bakersfield, CA · California$180.09+$0.17
  3. Chico, CA · California$179.92
  4. El Centro, CA · California$179.93+$0.01
  5. Fresno, CA · California$179.92
  6. Hanford, CA · California$179.92
  7. Los Angeles, CA · California$193.46+$13.54

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

78579 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$179.92—
Modesto, CACalifornia$179.92—
Napa, CACalifornia$213.52—
Oxnard, CACalifornia$193.02—
Redding, CACalifornia$179.92—
Rest of CaliforniaCalifornia$179.92—
Riverside, CACalifornia$180.57—
Sacramento, CACalifornia$190.16—

78579 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$144.45

$206.32

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78579 office rate range by state
State / territoryOffice rate rangeLocalities
AK$183.091
AL$146.931
AR$144.451
AZ$161.451
CA$179.92–$232.7229
CO$175.581
CT$178.501
DC$193.831
DE$164.431
FL$160.82–$175.483
GA$150.70–$169.162
GU$185.811
HI$185.811
IA$152.521
ID$153.421
IL$154.56–$172.004
IN$154.481
KS$151.111
KY$149.701
LA$149.20–$157.862
MA$174.05–$195.542
MD$168.11–$193.833
ME$153.71–$164.262
MI$153.69–$162.522
MN$169.231
MO$145.82–$159.223
MS$145.201
MT$166.331
NC$155.681
ND$165.151
NE$153.671
NH$172.171
NJ$180.82–$191.212
NM$154.431
NV$166.151
NY$158.33–$197.115
OH$153.451
OK$150.021
OR$165.15–$182.542
PA$154.07–$173.092
PR$167.941
RI$171.321
SC$154.771
SD$165.011
TN$151.911
TX$152.85–$174.748
UT$157.231
VA$163.23–$193.832
VI$167.941
VT$163.861
WA$173.93–$200.442
WI$158.721
WV$147.771
WY$165.821

See 78579 in every payment locality

How the 78579 rate is calculated

Each of 78579’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 · 78579

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.48

0.48 RVUs× 1.000 GPCI

Practice expense4.44

4.44 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

4.9800

Conversion factor

$33.4009

Medicare rate

$166.34

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Merced, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,425

Code
78579
Physician work
0.48
Practice expense
4.44
Malpractice
0.06

GPCI2026.csv

15

Locality
Merced, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office calculation for 78579 in Merced, CA
ComponentRVULocality factorAdjusted
Physician work0.48× 1.0170.4882
Practice expense4.44× 1.0964.8662
Malpractice0.06× 0.5360.0322
Total RVUs5.3866
Conversion factor× 33.4009

Office rate, Merced, CA$179.92

Office: (0.48 × 1.017 + 4.44 × 1.096 + 0.06 × 0.536) × $33.4009 = $179.92

Open 78579 in the RVU calculator

Payment rules and modifiers for 78579

The CMS indicators that decide how 78579 is paid alongside other services.

CMS payment indicators · 78579

Lung scan, ventilation only

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78579 without 26 · national office

$166.34

Lung scan, ventilation only

78579-26 · Professional component

$22.38

Pays only the interpretation and report.

When to use modifier 26

How 78579 has changed in Merced, CA

78579 · Office / nonfacility

$179.92

Effective 2026-10-01

The base rate is $3.14 higher than on 2025-10-01, moving from $176.78 to $179.92 (1.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $176.78changed to$179.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.49 changed to 0.48
    • Practice expense RVU 4.52 changed to 4.44
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $185.93changed to$176.78

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.63 changed to 4.52

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $182.89changed to$185.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $191.08changed to$182.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.73 changed to 4.63
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $193.72changed to$191.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.75 changed to 4.73
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $202.76changed to$193.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.95 changed to 4.75

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $205.28changed to$202.76

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.82 changed to 4.95
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $205.77changed to$205.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.83 changed to 4.82
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $210.00changed to$205.77

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.94 changed to 4.83
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $209.02changed to$210.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.91 changed to 4.94
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$209.02

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$179.92Not available in this settingRVU26D
2026-07-01$179.92Not available in this settingRVU26C
2026-04-01$179.92Not available in this settingRVU26B
2026-01-01$179.92Not available in this settingRVU26A
2025-10-01$176.78Not available in this settingRVU25D
2025-07-01$176.78Not available in this settingRVU25C
2025-04-01$176.78Not available in this settingRVU25B
2025-01-01$176.78Not available in this settingRVU25A
2024-10-01$185.93Not available in this settingRVU24D
2024-07-01$185.93Not available in this settingRVU24C
2024-04-01$185.93Not available in this settingRVU24B
2024-03-09$185.93Not available in this settingRVU24AR
2024-01-01$182.89Not available in this settingRVU24A
2023-10-01$191.08Not available in this settingRVU23D
2023-07-01$191.08Not available in this settingRVU23C
2023-04-01$191.08Not available in this settingRVU23B
2023-01-01$191.08Not available in this settingRVU23A
2022-10-01$193.72Not available in this settingRVU22D
2022-07-01$193.72Not available in this settingRVU22C
2022-04-01$193.72Not available in this settingRVU22B
2022-01-01$193.72Not available in this settingRVU22A
2021-10-01$202.76Not available in this settingRVU21D
2021-07-01$202.76Not available in this settingRVU21C
2021-04-01$202.76Not available in this settingRVU21B
2021-01-01$202.76Not available in this settingRVU21A
2020-10-01$205.28Not available in this settingRVU20D
2020-07-01$205.28Not available in this settingRVU20C
2020-04-01$205.28Not available in this settingRVU20B
2020-01-01$205.28Not available in this settingRVU20A
2019-10-01$205.77Not available in this settingRVU19D
2019-07-01$205.77Not available in this settingRVU19C
2019-04-01$205.77Not available in this settingRVU19B
2019-01-01$205.77Not available in this settingRVU19A
2018-10-01$210.00Not available in this settingRVU18D
2018-07-01$210.00Not available in this settingRVU18C
2018-04-01$210.00Not available in this settingRVU18B
2018-01-01$210.00Not available in this settingRVU18AR1
2017-10-01$209.02Not available in this settingRVU17D
2017-07-01$209.02Not available in this settingRVU17C
2017-04-01$209.02Not available in this settingRVU17B
2017-01-01$209.02Not available in this settingRVU17A
2016-10-01Rate data unavailableNot available in this settingRVU16D
2016-07-01Rate data unavailableNot available in this settingRVU16C
2016-04-01Rate data unavailableNot available in this settingRVU16B
2016-01-01Rate data unavailableNot available in this settingRVU16A
2015-10-01Rate data unavailableNot available in this settingRVU15D
2015-07-01Rate data unavailableNot available in this settingRVU15C
2015-04-01Rate data unavailableNot available in this settingRVU15B
2015-01-01Rate data unavailableNot available in this settingRVU15A
2014-10-01Rate data unavailableNot available in this settingRVU14D
2014-07-01Rate data unavailableNot available in this settingRVU14C
2014-04-01Rate data unavailableNot available in this settingRVU14B
2014-01-01Rate data unavailableNot available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 78579 for an earlier date of service

Where the Merced, CA rate applies

Merced, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Merced
  • Atwater
  • Ballico
  • Bear Creek
  • Cressey
  • Delhi
  • Dos Palos
  • Dos Palos Y

Browse all communities in California

78579 billing questions

How is this different from 78582?

78579 represents ventilation imaging alone. Use 78582 when the performed study includes both ventilation and perfusion imaging.

When would 78580 be used instead?

78580 represents lung perfusion imaging. It is the relevant code when the imaging evaluates tracer distribution in pulmonary blood flow rather than inhaled ventilation.

Which modifiers identify the components?

Use modifier 26 for the professional interpretation and modifier TC for the technical service. Submit without either modifier for the global service.

What documentation supports reporting 78579?

Document that ventilation imaging was performed, the inhaled tracer study acquired, and the interpretation. The record should distinguish a ventilation-only service from combined ventilation and perfusion imaging.

Can ventilation imaging be billed with perfusion imaging?

When both components are performed as a combined ventilation-and-perfusion study, 78582 describes that combined service. Do not treat 78579 as the code for the combined examination.

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
RVUs for 78579PPRRVU2026_Oct_nonQPP.csv, line 9,425 (RVU26D)
Geographic factors for Merced, CAGPCI2026.csv, line 15 (RVU26D)

Open CMS sourceHow we calculate rates

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