CPT code 78579: Lung scan, ventilation only2026 Medicare rate & RVUs in Missouri
Reports nuclear medicine imaging of inhaled tracer distribution in the lungs, commonly as the ventilation portion of an evaluation for suspected pulmonary embolism.
Medicare pays $145.82–$159.22 for 78579 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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.
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On this page 9 sections
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.
Where 78579 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$145.82 to $159.22
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $157.24 | Unavailable |
| Metropolitan St. Louis, MO | $159.22 | Unavailable |
| Rest of Missouri | $145.82 | Unavailable |
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
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.
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
| 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
78579 without 26 · national office
$166.34
Lung scan, ventilation only
78579-26 · Professional component
$22.38
Pays only the interpretation and report.
78579 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78580Lung perfusion scanPerfusion only
- Choose 78580 for lung perfusion imaging, which evaluates pulmonary blood-flow distribution. This code is for inhaled-tracer ventilation imaging.
- 78582Lung scanVentilation and perfusion
- Choose 78582 when both ventilation and perfusion imaging are performed as a combined study; 78579 describes ventilation imaging alone.
- 78598Lung V/Q imagingDifferential ventilation and perfusion
- 78598 is for differential ventilation and perfusion imaging. Use 78579 for ventilation imaging that is not reported as that differential study.
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.
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