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CPT code 78598: Lung V/Q imaging, differential ventilation and perfusion2026 Medicare rate & RVUs in Delaware

Reports a nuclear medicine study measuring the relative ventilation and perfusion of lung regions, often for preoperative assessment of remaining lung function.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In Delaware, Medicare pays $261.89 for 78598 in the office.

$261.89Office (non-facility)
Not available in this settingHospital or facility
−1.1%vs the national office rate ($264.87)

Check a contract rate as a % of Medicare · 78598 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 78598 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 78598 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 78598 covers

This nuclear medicine examination images both airflow and blood flow in the lungs and measures their relative distribution between lung regions. A patient being evaluated for lung resection may undergo the study to help estimate how much functioning lung would remain. Imaging staff administer and acquire the ventilation and perfusion portions; a radiologist or nuclear medicine physician interprets the images and differential results. The examination may be performed in a hospital department or imaging center.

Select 78598 when the completed study includes both ventilation and perfusion imaging with differential measurements. The report should identify the two portions of the examination and document the regional results, rather than describe only a standard combined scan. For Medicare physician fee schedule billing, modifier 26 identifies the physician’s interpretation, and modifier TC identifies the equipment-and-staff portion. A claim without either modifier represents the global service, combining both components. A completed dual-portion differential examination is reported with this combined code rather than separate single-portion imaging codes.

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 Delaware compares for 78598

Across 109 of 109 payment localities, the office rate for 78598 runs from $230.40 in Arkansas to $370.01 in San Benito County, CA. Delaware pays $261.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

78598 in Delaware vs other payment areas
  1. Delaware · this page$261.89
  2. Los Angeles, CA · California$307.84+$45.95
  3. Washington, DC area · District of Columbia$308.38+$46.49
  4. Miami, FL · Florida$279.07+$17.18
  5. Chicago, IL · Illinois$270.13+$8.24
  6. Manhattan, NY · New York$306.34+$44.45
  7. Alaska · Alaska$292.60+$30.71

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

Every other payment area

78598 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$234.30—
ArkansasArkansas$230.40—
ArizonaArizona$257.18—
Bakersfield, CACalifornia$286.70—
Chico, CACalifornia$286.42—
El Centro, CACalifornia$286.44—
Fresno, CACalifornia$286.42—
Hanford, CACalifornia$286.42—

78598 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$230.40

$328.22

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

View every state and territory as a table
78598 office rate range by state
State / territoryOffice rate rangeLocalities
AK$292.601
AL$234.301
AR$230.401
AZ$257.181
CA$286.42–$370.0129
CO$279.531
CT$284.081
DC$308.381
DE$261.891
FL$256.08–$279.073
GA$240.16–$269.302
GU$295.681
HI$295.681
IA$243.151
ID$244.551
IL$246.19–$273.714
IN$246.231
KS$240.901
KY$238.621
LA$237.82–$251.462
MA$277.11–$311.102
MD$267.71–$308.383
ME$245.00–$261.652
MI$244.89–$258.742
MN$269.541
MO$232.48–$253.643
MS$231.541
MT$264.861
NC$248.101
ND$263.081
NE$244.971
NH$274.091
NJ$287.81–$304.282
NM$246.041
NV$264.601
NY$252.27–$313.475
OH$244.521
OK$239.151
OR$263.04–$290.532
PA$245.50–$275.552
PR$267.401
RI$272.801
SC$246.621
SD$262.871
TN$242.171
TX$243.58–$278.168
UT$250.511
VA$260.00–$308.382
VI$267.401
VT$261.041
WA$276.92–$318.862
WI$252.961
WV$235.491
WY$264.091

See 78598 in every payment locality

How the 78598 rate is calculated

Each of 78598’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 · 78598

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.83

0.83 RVUs× 1.000 GPCI

Practice expense7.01

7.01 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

7.9300

Conversion factor

$33.4009

Medicare rate

$264.87

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,437

Code
78598
Physician work
0.83
Practice expense
7.01
Malpractice
0.09

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 78598 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0050.8341
Practice expense7.01× 0.9886.9259
Malpractice0.09× 0.8990.0809
Total RVUs7.8409
Conversion factor× 33.4009

Office rate, Delaware$261.89

Office: (0.83 × 1.005 + 7.01 × 0.988 + 0.09 × 0.899) × $33.4009 = $261.89

Open 78598 in the RVU calculator

Payment rules and modifiers for 78598

The CMS indicators that decide how 78598 is paid alongside other services.

CMS payment indicators · 78598

Lung V/Q imaging, differential ventilation and perfusion

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

78598 without 26 · national office

$264.87

Lung V/Q imaging, differential ventilation and perfusion

78598-26 · Professional component

$37.74

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78598

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78598
CodeHow it relatesOffice range, Delaware
Same family
78582Lung scan, ventilation and perfusionCombined ventilation and perfusion imaging without differential measurements.$287.36
78597Lung perfusion, differential quantificationDifferential perfusion imaging without the combined differential ventilation service.$178.11
78579Lung scan, ventilation onlyVentilation imaging alone, rather than combined differential ventilation and perfusion.$164.43
78580Lung perfusion scan, perfusion onlyPerfusion imaging alone, rather than combined differential ventilation and perfusion.$207.08

How 78598 has changed in Delaware

78598 · Office / nonfacility

$261.89

Effective 2026-10-01

The base rate is $2.89 higher than on 2025-10-01, moving from $259.00 to $261.89 (1.1%).

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

    $259.00changed to$261.89

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Practice expense RVU 7.14 changed to 7.01
    • Malpractice RVU 0.07 changed to 0.09
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $273.12changed to$259.00

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.33 changed to 7.14
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $268.66changed to$273.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $287.82changed to$268.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.51 changed to 7.33
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $303.40changed to$287.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.67 changed to 7.51
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $318.04changed to$303.40

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.01 changed to 7.67

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $320.12changed to$318.04

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.77 changed to 8.01
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $323.09changed to$320.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.87 changed to 7.77
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $327.87changed to$323.09

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.01 changed to 7.87

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $328.99changed to$327.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.02 changed to 8.01
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $329.95changed to$328.99

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $328.90changed to$329.95

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.97 changed to 8.02
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $327.27changed to$328.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $324.60changed to$327.27

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.85 changed to 7.97
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $378.38changed to$324.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.79 changed to 7.85
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $378.38

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$261.89Not available in this settingRVU26D
2026-07-01$261.89Not available in this settingRVU26C
2026-04-01$261.89Not available in this settingRVU26B
2026-01-01$261.89Not available in this settingRVU26A
2025-10-01$259.00Not available in this settingRVU25D
2025-07-01$259.00Not available in this settingRVU25C
2025-04-01$259.00Not available in this settingRVU25B
2025-01-01$259.00Not available in this settingRVU25A
2024-10-01$273.12Not available in this settingRVU24D
2024-07-01$273.12Not available in this settingRVU24C
2024-04-01$273.12Not available in this settingRVU24B
2024-03-09$273.12Not available in this settingRVU24AR
2024-01-01$268.66Not available in this settingRVU24A
2023-10-01$287.82Not available in this settingRVU23D
2023-07-01$287.82Not available in this settingRVU23C
2023-04-01$287.82Not available in this settingRVU23B
2023-01-01$287.82Not available in this settingRVU23A
2022-10-01$303.40Not available in this settingRVU22D
2022-07-01$303.40Not available in this settingRVU22C
2022-04-01$303.40Not available in this settingRVU22B
2022-01-01$303.40Not available in this settingRVU22A
2021-10-01$318.04Not available in this settingRVU21D
2021-07-01$318.04Not available in this settingRVU21C
2021-04-01$318.04Not available in this settingRVU21B
2021-01-01$318.04Not available in this settingRVU21A
2020-10-01$320.12Not available in this settingRVU20D
2020-07-01$320.12Not available in this settingRVU20C
2020-04-01$320.12Not available in this settingRVU20B
2020-01-01$320.12Not available in this settingRVU20A
2019-10-01$323.09Not available in this settingRVU19D
2019-07-01$323.09Not available in this settingRVU19C
2019-04-01$323.09Not available in this settingRVU19B
2019-01-01$323.09Not available in this settingRVU19A
2018-10-01$327.87Not available in this settingRVU18D
2018-07-01$327.87Not available in this settingRVU18C
2018-04-01$327.87Not available in this settingRVU18B
2018-01-01$327.87Not available in this settingRVU18AR1
2017-10-01$328.99Not available in this settingRVU17D
2017-07-01$328.99Not available in this settingRVU17C
2017-04-01$328.99Not available in this settingRVU17B
2017-01-01$328.99Not available in this settingRVU17A
2016-10-01$329.95Not available in this settingRVU16D
2016-07-01$329.95Not available in this settingRVU16C
2016-04-01$329.95Not available in this settingRVU16B
2016-01-01$329.95Not available in this settingRVU16A
2015-10-01$328.90Not available in this settingRVU15D
2015-07-01$328.90Not available in this settingRVU15C
2015-04-01$327.27Not available in this settingRVU15B
2015-01-01$327.27Not available in this settingRVU15A
2014-10-01$324.60Not available in this settingRVU14D
2014-07-01$324.60Not available in this settingRVU14C
2014-04-01$324.60Not available in this settingRVU14B
2014-01-01$324.60Not available in this settingRVU14A
2013-10-01$378.38Not available in this settingRVU13D
2013-07-01$378.38Not available in this settingRVU13C
2013-04-01$378.38Not available in this settingRVU13B
2013-01-01$378.38Not available in this settingRVU13AR

Price 78598 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

78598 billing questions

How is 78598 different from 78582?

Both involve ventilation and perfusion imaging. Use 78598 when the examination also measures their differential distribution between lung regions; 78582 describes the combined imaging without that differential measurement.

When would 78597 be reported instead?

78597 is for differential perfusion imaging. Choose 78598 when differential ventilation is measured along with differential perfusion.

Should ventilation and perfusion be reported as two single-portion codes?

For one completed examination that measures both portions differentially, report the combined service with 78598 rather than splitting it into ventilation-only and perfusion-only codes.

Which component does modifier 26 identify?

Modifier 26 identifies the physician’s interpretation and report of the differential ventilation and perfusion study. Modifier TC identifies the equipment-and-staff portion; billing without either modifier represents both components.

What should the report show to support 78598?

It should document that both ventilation and perfusion imaging were performed and include the differential regional findings. A report describing only perfusion measurements does not establish the combined differential service.

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 78598PPRRVU2026_Oct_nonQPP.csv, line 9,437 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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