CPT code 78582: Lung scan, ventilation and perfusion2026 Medicare rate & RVUs in Montana
Reports paired lung ventilation and perfusion imaging, commonly used to evaluate suspected pulmonary embolism by comparing airflow and blood-flow patterns.
In Montana, Medicare pays $290.58 for 78582 in the office.
Check a contract rate as a % of Medicare · 78582 nationwide
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 11 sections
What 78582 covers
A nuclear medicine team acquires images of air distribution after the patient inhales a radiotracer and blood flow after an intravenous radiotracer. A nuclear medicine physician interprets the paired patterns, often for evaluation of suspected pulmonary embolism. The study is typically performed in a hospital or outpatient imaging department, with imaging staff handling tracer administration and acquisition.
Report 78582 when both ventilation and perfusion imaging are performed as a paired lung study; ventilation-only or perfusion-only imaging is reported with a different code. Documentation should support both portions of the examination and include the resulting interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or no component modifier for 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.
How Montana compares for 78582
Across 109 of 109 payment localities, the office rate for 78582 runs from $253.25 in Arkansas to $404.17 in San Benito County, CA. Montana pays $290.58. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$290.58
- Los Angeles, CA · California$336.93+$46.35
- Washington, DC area · District of Columbia$337.77+$47.19
- Miami, FL · Florida$306.54+$15.96
- Chicago, IL · Illinois$296.85+$6.27
- Manhattan, NY · New York$335.82+$45.24
- Alaska · Alaska$322.70+$32.12
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $257.47 | — |
| ArkansasArkansas | $253.25 | — |
| ArizonaArizona | $282.24 | — |
| Bakersfield, CACalifornia | $314.02 | — |
| Chico, CACalifornia | $313.68 | — |
| El Centro, CACalifornia | $313.70 | — |
| Fresno, CACalifornia | $313.68 | — |
| Hanford, CACalifornia | $313.68 | — |
| Madera, CACalifornia | $313.68 | — |
| Merced, CACalifornia | $313.68 | — |
| Modesto, CACalifornia | $313.68 | — |
| Napa, CACalifornia | $371.16 | — |
| Oxnard, CACalifornia | $336.07 | — |
| Redding, CACalifornia | $313.68 | — |
| Rest of CaliforniaCalifornia | $313.68 | — |
| Riverside, CACalifornia | $314.88 | — |
| Sacramento, CACalifornia | $331.24 | — |
| Salinas, CACalifornia | $330.06 | — |
| San Diego, CACalifornia | $339.37 | — |
| Marin County, CACalifornia | $395.29 | — |
| San Francisco, CACalifornia | $395.17 | — |
| San Benito County, CACalifornia | $404.17 | — |
| Santa Clara County, CACalifornia | $403.66 | — |
| San Luis Obispo, CACalifornia | $324.53 | — |
| Santa Cruz, CACalifornia | $343.83 | — |
| Santa Maria, CACalifornia | $331.72 | — |
| Santa Rosa, CACalifornia | $347.42 | — |
| Stockton, CACalifornia | $313.68 | — |
| Vallejo, CACalifornia | $370.98 | — |
| Visalia, CACalifornia | $313.68 | — |
| Yuba City, CACalifornia | $313.68 | — |
| ColoradoColorado | $306.34 | — |
| ConnecticutConnecticut | $311.47 | — |
| DelawareDelaware | $287.36 | — |
| Fort Lauderdale, FLFlorida | $296.83 | — |
| Rest of FloridaFlorida | $281.34 | — |
| Atlanta, GAGeorgia | $295.47 | — |
| Rest of GeorgiaGeorgia | $264.06 | — |
| Hawaii, Guam, HIHawaii | $323.59 | — |
| IowaIowa | $266.94 | — |
| IdahoIdaho | $268.48 | — |
| East St. Louis, ILIllinois | $274.14 | — |
| Rest of IllinoisIllinois | $270.72 | — |
| Suburban Chicago, ILIllinois | $300.48 | — |
| IndianaIndiana | $270.29 | — |
| KansasKansas | $264.56 | — |
| KentuckyKentucky | $262.28 | — |
| New Orleans, LALouisiana | $276.21 | — |
| Rest of LouisianaLouisiana | $261.43 | — |
| Metropolitan Boston, MAMassachusetts | $340.53 | — |
| Rest of MassachusettsMassachusetts | $303.76 | — |
| Baltimore area, MDMaryland | $310.42 | — |
| Rest of MarylandMaryland | $293.66 | — |
| Rest of MaineMaine | $269.02 | — |
| Southern Maine, MEMaine | $286.96 | — |
| Detroit, MIMichigan | $284.28 | — |
| Rest of MichiganMichigan | $269.12 | — |
| MinnesotaMinnesota | $295.31 | — |
| Metropolitan Kansas City, MOMissouri | $275.12 | — |
| Metropolitan St. Louis, MOMissouri | $278.49 | — |
| Rest of MissouriMissouri | $255.69 | — |
| MississippiMississippi | $254.58 | — |
| North CarolinaNorth Carolina | $272.37 | — |
| North DakotaNorth Dakota | $288.41 | — |
| NebraskaNebraska | $268.88 | — |
| New HampshireNew Hampshire | $300.47 | — |
| Northern New JerseyNew Jersey | $333.37 | — |
| Rest of New JerseyNew Jersey | $315.53 | — |
| New MexicoNew Mexico | $270.40 | — |
| NevadaNevada | $290.23 | — |
| NYC suburbs and Long Island, NYNew York | $343.62 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $316.88 | — |
| Queens, NYNew York | $340.33 | — |
| Rest of New YorkNew York | $276.89 | — |
| OhioOhio | $268.68 | — |
| OklahomaOklahoma | $262.79 | — |
| Portland, OROregon | $318.19 | — |
| Rest of OregonOregon | $288.49 | — |
| Metropolitan Philadelphia, PAPennsylvania | $302.26 | — |
| Rest of PennsylvaniaPennsylvania | $269.71 | — |
| Puerto RicoPuerto Rico | $293.31 | — |
| Rhode IslandRhode Island | $299.17 | — |
| South CarolinaSouth Carolina | $270.87 | — |
| South DakotaSouth Dakota | $288.15 | — |
| TennesseeTennessee | $265.94 | — |
| Austin, TXTexas | $304.86 | — |
| Beaumont, TXTexas | $267.63 | — |
| Brazoria, TXTexas | $287.79 | — |
| Dallas, TXTexas | $289.37 | — |
| Fort Worth, TXTexas | $286.90 | — |
| Galveston, TXTexas | $288.47 | — |
| Houston, TXTexas | $290.48 | — |
| Rest of TexasTexas | $277.37 | — |
| UtahUtah | $275.08 | — |
| VirginiaVirginia | $285.22 | — |
| Virgin Islands, VIUnited States Virgin Islands | $293.31 | — |
| VermontVermont | $286.25 | — |
| Rest of WashingtonWashington | $303.53 | — |
| King County, WAWashington | $348.90 | — |
| WisconsinWisconsin | $277.45 | — |
| West VirginiaWest Virginia | $259.14 | — |
| WyomingWyoming | $289.63 | — |
78582 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.
$253.25
$358.93
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $322.70 | 1 |
| AL | $257.47 | 1 |
| AR | $253.25 | 1 |
| AZ | $282.24 | 1 |
| CA | $313.68–$404.17 | 29 |
| CO | $306.34 | 1 |
| CT | $311.47 | 1 |
| DC | $337.77 | 1 |
| DE | $287.36 | 1 |
| FL | $281.34–$306.54 | 3 |
| GA | $264.06–$295.47 | 2 |
| GU | $323.59 | 1 |
| HI | $323.59 | 1 |
| IA | $266.94 | 1 |
| ID | $268.48 | 1 |
| IL | $270.72–$300.48 | 4 |
| IN | $270.29 | 1 |
| KS | $264.56 | 1 |
| KY | $262.28 | 1 |
| LA | $261.43–$276.21 | 2 |
| MA | $303.76–$340.53 | 2 |
| MD | $293.66–$337.77 | 3 |
| ME | $269.02–$286.96 | 2 |
| MI | $269.12–$284.28 | 2 |
| MN | $295.31 | 1 |
| MO | $255.69–$278.49 | 3 |
| MS | $254.58 | 1 |
| MT | $290.58 | 1 |
| NC | $272.37 | 1 |
| ND | $288.41 | 1 |
| NE | $268.88 | 1 |
| NH | $300.47 | 1 |
| NJ | $315.53–$333.37 | 2 |
| NM | $270.40 | 1 |
| NV | $290.23 | 1 |
| NY | $276.89–$343.62 | 5 |
| OH | $268.68 | 1 |
| OK | $262.79 | 1 |
| OR | $288.49–$318.19 | 2 |
| PA | $269.71–$302.26 | 2 |
| PR | $293.31 | 1 |
| RI | $299.17 | 1 |
| SC | $270.87 | 1 |
| SD | $288.15 | 1 |
| TN | $265.94 | 1 |
| TX | $267.63–$304.86 | 8 |
| UT | $275.08 | 1 |
| VA | $285.22–$337.77 | 2 |
| VI | $293.31 | 1 |
| VT | $286.25 | 1 |
| WA | $303.53–$348.90 | 2 |
| WI | $277.45 | 1 |
| WV | $259.14 | 1 |
| WY | $289.63 | 1 |
How the 78582 rate is calculated
Each of 78582’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 · 78582
RVUs × geographic indexes × conversion factor
Work1.04
1.04 RVUs× 1.000 GPCI
Practice expense7.55
7.55 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
8.7000
Conversion factor
$33.4009
Medicare rate
$290.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
9,431
- Code
- 78582
- Physician work
- 1.04
- Practice expense
- 7.55
- Malpractice
- 0.11
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.04 | × 1.000 | 1.0400 |
| Practice expense | 7.55 | × 1.000 | 7.5500 |
| Malpractice | 0.11 | × 0.998 | 0.1098 |
| Total RVUs | 8.6998 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$290.58
Office: (1.04 × 1 + 7.55 × 1 + 0.11 × 0.998) × $33.4009 = $290.58
Payment rules and modifiers for 78582
The CMS indicators that decide how 78582 is paid alongside other services.
CMS payment indicators · 78582
Lung scan, ventilation and perfusion
| 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
78582 without 26 · national office
$290.59
Lung scan, ventilation and perfusion
78582-26 · Professional component
$48.43
Pays only the interpretation and report.
How 78582 has changed in Montana
78582 · Office / nonfacility
$290.58
Effective 2026-10-01
The base rate is $3.08 higher than on 2025-10-01, moving from $287.50 to $290.58 (1.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$287.50changed to$290.58
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.07 changed to 1.04
- Practice expense RVU 7.74 changed to 7.55
- Malpractice RVU 0.08 changed to 0.11
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$302.84changed to$287.50
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.93 changed to 7.74
- Malpractice RVU 0.10 changed to 0.08
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$297.90changed to$302.84
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$313.74changed to$297.90
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.11 changed to 7.93
- Malpractice RVU 0.08 changed to 0.10
January 1, 2023
RVU23A
$325.57changed to$313.74
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.25 changed to 8.11
- Malpractice RVU 0.09 changed to 0.08
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$341.53changed to$325.57
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.63 changed to 8.25
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$345.39changed to$341.53
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.37 changed to 8.63
- Malpractice RVU 0.10 changed to 0.09
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$349.69changed to$345.39
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.47 changed to 8.37
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$355.07changed to$349.69
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.63 changed to 8.47
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$352.89changed to$355.07
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.62 changed to 8.63
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$350.62changed to$352.89
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.60 changed to 8.62
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$349.92changed to$350.62
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.57 changed to 8.60
- Malpractice RVU 0.08 changed to 0.10
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$348.18changed to$349.92
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$343.30changed to$348.18
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.42 changed to 8.57
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$343.30
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $290.58 | Not available in this setting | RVU26D |
| 2026-07-01 | $290.58 | Not available in this setting | RVU26C |
| 2026-04-01 | $290.58 | Not available in this setting | RVU26B |
| 2026-01-01 | $290.58 | Not available in this setting | RVU26A |
| 2025-10-01 | $287.50 | Not available in this setting | RVU25D |
| 2025-07-01 | $287.50 | Not available in this setting | RVU25C |
| 2025-04-01 | $287.50 | Not available in this setting | RVU25B |
| 2025-01-01 | $287.50 | Not available in this setting | RVU25A |
| 2024-10-01 | $302.84 | Not available in this setting | RVU24D |
| 2024-07-01 | $302.84 | Not available in this setting | RVU24C |
| 2024-04-01 | $302.84 | Not available in this setting | RVU24B |
| 2024-03-09 | $302.84 | Not available in this setting | RVU24AR |
| 2024-01-01 | $297.90 | Not available in this setting | RVU24A |
| 2023-10-01 | $313.74 | Not available in this setting | RVU23D |
| 2023-07-01 | $313.74 | Not available in this setting | RVU23C |
| 2023-04-01 | $313.74 | Not available in this setting | RVU23B |
| 2023-01-01 | $313.74 | Not available in this setting | RVU23A |
| 2022-10-01 | $325.57 | Not available in this setting | RVU22D |
| 2022-07-01 | $325.57 | Not available in this setting | RVU22C |
| 2022-04-01 | $325.57 | Not available in this setting | RVU22B |
| 2022-01-01 | $325.57 | Not available in this setting | RVU22A |
| 2021-10-01 | $341.53 | Not available in this setting | RVU21D |
| 2021-07-01 | $341.53 | Not available in this setting | RVU21C |
| 2021-04-01 | $341.53 | Not available in this setting | RVU21B |
| 2021-01-01 | $341.53 | Not available in this setting | RVU21A |
| 2020-10-01 | $345.39 | Not available in this setting | RVU20D |
| 2020-07-01 | $345.39 | Not available in this setting | RVU20C |
| 2020-04-01 | $345.39 | Not available in this setting | RVU20B |
| 2020-01-01 | $345.39 | Not available in this setting | RVU20A |
| 2019-10-01 | $349.69 | Not available in this setting | RVU19D |
| 2019-07-01 | $349.69 | Not available in this setting | RVU19C |
| 2019-04-01 | $349.69 | Not available in this setting | RVU19B |
| 2019-01-01 | $349.69 | Not available in this setting | RVU19A |
| 2018-10-01 | $355.07 | Not available in this setting | RVU18D |
| 2018-07-01 | $355.07 | Not available in this setting | RVU18C |
| 2018-04-01 | $355.07 | Not available in this setting | RVU18B |
| 2018-01-01 | $355.07 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $352.89 | Not available in this setting | RVU17D |
| 2017-07-01 | $352.89 | Not available in this setting | RVU17C |
| 2017-04-01 | $352.89 | Not available in this setting | RVU17B |
| 2017-01-01 | $352.89 | Not available in this setting | RVU17A |
| 2016-10-01 | $350.62 | Not available in this setting | RVU16D |
| 2016-07-01 | $350.62 | Not available in this setting | RVU16C |
| 2016-04-01 | $350.62 | Not available in this setting | RVU16B |
| 2016-01-01 | $350.62 | Not available in this setting | RVU16A |
| 2015-10-01 | $349.92 | Not available in this setting | RVU15D |
| 2015-07-01 | $349.92 | Not available in this setting | RVU15C |
| 2015-04-01 | $348.18 | Not available in this setting | RVU15B |
| 2015-01-01 | $348.18 | Not available in this setting | RVU15A |
| 2014-10-01 | $343.30 | Not available in this setting | RVU14D |
| 2014-07-01 | $343.30 | Not available in this setting | RVU14C |
| 2014-04-01 | $343.30 | Not available in this setting | RVU14B |
| 2014-01-01 | $343.30 | Not available in this setting | RVU14A |
| 2013-10-01 | Additional calculation required | Not available in this setting | RVU13D |
| 2013-07-01 | Additional calculation required | Not available in this setting | RVU13C |
| 2013-04-01 | Additional calculation required | Not available in this setting | RVU13B |
| 2013-01-01 | Additional calculation required | Not available in this setting | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
78582 billing questions
When should 78582 be chosen over 78579 or 78580?
Use 78582 when the examination includes both ventilation and perfusion imaging. Code 78579 is for ventilation imaging alone, and 78580 is for perfusion imaging alone.
How are the professional and technical services reported?
Use modifier 26 for the physician's interpretation and modifier TC for the technical service. Without either modifier, the code represents the global service.
What documentation supports reporting 78582?
The record should show that both ventilation and perfusion images were acquired and include the physician's interpretation of the study.
Is this the same as differential lung imaging?
No. 78582 reports paired ventilation and perfusion imaging; differential codes address quantitative assessment of lung-function distribution.
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
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