CPT code 78597: Lung perfusion, differential quantification2026 Medicare rate & RVUs in Michigan
Reports particulate-tracer lung perfusion imaging with quantitative comparison of pulmonary blood flow, often to assess function before planned lung resection.
Medicare pays $166.92–$176.03 for 78597 in the office in Michigan, from Rest of Michigan to Detroit, MI. 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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What 78597 covers
A nuclear medicine technologist administers a particulate radiotracer intravenously and acquires images showing how blood is distributed through the lungs. The study includes quantitative differential analysis, allowing comparison of perfusion between the lungs. A nuclear medicine physician interprets the images. A common clinical use is estimating each lung’s functional contribution before planned lung resection, such as pneumonectomy or lobectomy.
Select this service when the examination includes differential quantitative analysis of pulmonary perfusion, rather than perfusion imaging without that analysis or a combined ventilation-perfusion study. Documentation should identify the clinical question, tracer-based perfusion imaging, and the differential findings or quantitative analysis performed. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional portion, modifier TC for the technical portion, or neither modifier when billing 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.
Where 78597 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $176.03 | Unavailable |
| Rest of Michigan | $166.92 | Unavailable |
How the 78597 rate is calculated
Each of 78597’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 · 78597
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense4.60
4.60 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
5.3900
Conversion factor
$33.4009
Medicare rate
$180.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78597
The CMS indicators that decide how 78597 is paid alongside other services.
CMS payment indicators · 78597
Lung perfusion, differential quantification
| 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
78597 without 26 · national office
$180.03
Lung perfusion, differential quantification
78597-26 · Professional component
$33.07
Pays only the interpretation and report.
78597 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78580Lung perfusion scanPerfusion only
- Choose 78597 when the perfusion study includes differential quantitative analysis. Choose 78580 for particulate-tracer perfusion imaging without that analysis.
- 78598Lung V/Q imagingDifferential ventilation and perfusion
- 78598 covers differential quantitative assessment of both ventilation and perfusion; 78597 covers differential perfusion imaging only.
- 78582Lung scanVentilation and perfusion
- 78582 is a combined ventilation-perfusion study without differential quantification. 78597 is a perfusion-only study with differential quantitative analysis.
78597 billing questions
How is 78597 different from 78580?
78597 includes differential quantitative analysis of lung perfusion. Use 78580 for particulate-tracer perfusion imaging without that differential analysis.
When would 78598 be a better fit?
Use 78598 when the study includes differential quantitative evaluation of both lung ventilation and perfusion. 78597 is for differential perfusion imaging.
Can the interpretation and imaging portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion. Billing without either modifier represents the global service.
Is quantitative analysis separately reported?
The differential quantitative analysis is part of the service represented by 78597; it is not a separate service within this code.
What documentation supports reporting 78597?
Document the clinical reason for the scan, the particulate-tracer perfusion study, and the differential quantitative assessment of pulmonary perfusion.
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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