CPT code 78598: Lung V/Q imaging, differential ventilation and perfusion2026 Medicare rate & RVUs in South Dakota
Reports a nuclear medicine study measuring the relative ventilation and perfusion of lung regions, often for preoperative assessment of remaining lung function.
In South Dakota, Medicare pays $262.87 for 78598 in the office.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $262.87. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$262.87
- Los Angeles, CA · California$307.84+$44.97
- Washington, DC area · District of Columbia$308.38+$45.51
- Miami, FL · Florida$279.07+$16.20
- Chicago, IL · Illinois$270.13+$7.26
- Manhattan, NY · New York$306.34+$43.47
- Alaska · Alaska$292.60+$29.73
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $286.42 | — |
| Merced, CACalifornia | $286.42 | — |
| Modesto, CACalifornia | $286.42 | — |
| Napa, CACalifornia | $339.59 | — |
| Oxnard, CACalifornia | $307.13 | — |
| Redding, CACalifornia | $286.42 | — |
| Rest of CaliforniaCalifornia | $286.42 | — |
| Riverside, CACalifornia | $287.40 | — |
| Sacramento, CACalifornia | $302.64 | — |
| Salinas, CACalifornia | $301.56 | — |
| San Diego, CACalifornia | $310.22 | — |
| Marin County, CACalifornia | $361.87 | — |
| San Francisco, CACalifornia | $361.77 | — |
| San Benito County, CACalifornia | $370.01 | — |
| Santa Clara County, CACalifornia | $369.60 | — |
| San Luis Obispo, CACalifornia | $296.49 | — |
| Santa Cruz, CACalifornia | $314.40 | — |
| Santa Maria, CACalifornia | $303.12 | — |
| Santa Rosa, CACalifornia | $317.69 | — |
| Stockton, CACalifornia | $286.42 | — |
| Vallejo, CACalifornia | $339.45 | — |
| Visalia, CACalifornia | $286.42 | — |
| Yuba City, CACalifornia | $286.42 | — |
| ColoradoColorado | $279.53 | — |
| ConnecticutConnecticut | $284.08 | — |
| DelawareDelaware | $261.89 | — |
| Fort Lauderdale, FLFlorida | $270.34 | — |
| Rest of FloridaFlorida | $256.08 | — |
| Atlanta, GAGeorgia | $269.30 | — |
| Rest of GeorgiaGeorgia | $240.16 | — |
| Hawaii, Guam, HIHawaii | $295.68 | — |
| IowaIowa | $243.15 | — |
| IdahoIdaho | $244.55 | — |
| East St. Louis, ILIllinois | $249.19 | — |
| Rest of IllinoisIllinois | $246.19 | — |
| Suburban Chicago, ILIllinois | $273.71 | — |
| IndianaIndiana | $246.23 | — |
| KansasKansas | $240.90 | — |
| KentuckyKentucky | $238.62 | — |
| New Orleans, LALouisiana | $251.46 | — |
| Rest of LouisianaLouisiana | $237.82 | — |
| Metropolitan Boston, MAMassachusetts | $311.10 | — |
| Rest of MassachusettsMassachusetts | $277.11 | — |
| Baltimore area, MDMaryland | $283.12 | — |
| Rest of MarylandMaryland | $267.71 | — |
| Rest of MaineMaine | $245.00 | — |
| Southern Maine, MEMaine | $261.65 | — |
| Detroit, MIMichigan | $258.74 | — |
| Rest of MichiganMichigan | $244.89 | — |
| MinnesotaMinnesota | $269.54 | — |
| Metropolitan Kansas City, MOMissouri | $250.52 | — |
| Metropolitan St. Louis, MOMissouri | $253.64 | — |
| Rest of MissouriMissouri | $232.48 | — |
| MississippiMississippi | $231.54 | — |
| MontanaMontana | $264.86 | — |
| North CarolinaNorth Carolina | $248.10 | — |
| North DakotaNorth Dakota | $263.08 | — |
| NebraskaNebraska | $244.97 | — |
| New HampshireNew Hampshire | $274.09 | — |
| Northern New JerseyNew Jersey | $304.28 | — |
| Rest of New JerseyNew Jersey | $287.81 | — |
| New MexicoNew Mexico | $246.04 | — |
| NevadaNevada | $264.60 | — |
| NYC suburbs and Long Island, NYNew York | $313.47 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $288.99 | — |
| Queens, NYNew York | $310.59 | — |
| Rest of New YorkNew York | $252.27 | — |
| OhioOhio | $244.52 | — |
| OklahomaOklahoma | $239.15 | — |
| Portland, OROregon | $290.53 | — |
| Rest of OregonOregon | $263.04 | — |
| Metropolitan Philadelphia, PAPennsylvania | $275.55 | — |
| Rest of PennsylvaniaPennsylvania | $245.50 | — |
| Puerto RicoPuerto Rico | $267.40 | — |
| Rhode IslandRhode Island | $272.80 | — |
| South CarolinaSouth Carolina | $246.62 | — |
| TennesseeTennessee | $242.17 | — |
| Austin, TXTexas | $278.16 | — |
| Beaumont, TXTexas | $243.58 | — |
| Brazoria, TXTexas | $262.32 | — |
| Dallas, TXTexas | $263.76 | — |
| Fort Worth, TXTexas | $261.45 | — |
| Galveston, TXTexas | $262.93 | — |
| Houston, TXTexas | $264.58 | — |
| Rest of TexasTexas | $252.64 | — |
| UtahUtah | $250.51 | — |
| VirginiaVirginia | $260.00 | — |
| Virgin Islands, VIUnited States Virgin Islands | $267.40 | — |
| VermontVermont | $261.04 | — |
| Rest of WashingtonWashington | $276.92 | — |
| King County, WAWashington | $318.86 | — |
| WisconsinWisconsin | $252.96 | — |
| West VirginiaWest Virginia | $235.49 | — |
| WyomingWyoming | $264.09 | — |
78598 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.
$230.40
$328.22
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 | $292.60 | 1 |
| AL | $234.30 | 1 |
| AR | $230.40 | 1 |
| AZ | $257.18 | 1 |
| CA | $286.42–$370.01 | 29 |
| CO | $279.53 | 1 |
| CT | $284.08 | 1 |
| DC | $308.38 | 1 |
| DE | $261.89 | 1 |
| FL | $256.08–$279.07 | 3 |
| GA | $240.16–$269.30 | 2 |
| GU | $295.68 | 1 |
| HI | $295.68 | 1 |
| IA | $243.15 | 1 |
| ID | $244.55 | 1 |
| IL | $246.19–$273.71 | 4 |
| IN | $246.23 | 1 |
| KS | $240.90 | 1 |
| KY | $238.62 | 1 |
| LA | $237.82–$251.46 | 2 |
| MA | $277.11–$311.10 | 2 |
| MD | $267.71–$308.38 | 3 |
| ME | $245.00–$261.65 | 2 |
| MI | $244.89–$258.74 | 2 |
| MN | $269.54 | 1 |
| MO | $232.48–$253.64 | 3 |
| MS | $231.54 | 1 |
| MT | $264.86 | 1 |
| NC | $248.10 | 1 |
| ND | $263.08 | 1 |
| NE | $244.97 | 1 |
| NH | $274.09 | 1 |
| NJ | $287.81–$304.28 | 2 |
| NM | $246.04 | 1 |
| NV | $264.60 | 1 |
| NY | $252.27–$313.47 | 5 |
| OH | $244.52 | 1 |
| OK | $239.15 | 1 |
| OR | $263.04–$290.53 | 2 |
| PA | $245.50–$275.55 | 2 |
| PR | $267.40 | 1 |
| RI | $272.80 | 1 |
| SC | $246.62 | 1 |
| SD | $262.87 | 1 |
| TN | $242.17 | 1 |
| TX | $243.58–$278.16 | 8 |
| UT | $250.51 | 1 |
| VA | $260.00–$308.38 | 2 |
| VI | $267.40 | 1 |
| VT | $261.04 | 1 |
| WA | $276.92–$318.86 | 2 |
| WI | $252.96 | 1 |
| WV | $235.49 | 1 |
| WY | $264.09 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 7.01 | × 1.000 | 7.0100 |
| Malpractice | 0.09 | × 0.336 | 0.0302 |
| Total RVUs | 7.8702 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$262.87
Office: (0.83 × 1 + 7.01 × 1 + 0.09 × 0.336) × $33.4009 = $262.87
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
| 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
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.
How 78598 has changed in South Dakota
78598 · Office / nonfacility
$262.87
Effective 2026-10-01
The base rate is $3.56 higher than on 2025-10-01, moving from $259.31 to $262.87 (1.4%).
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
$259.31changed to$262.87
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$273.31changed to$259.31
- 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.
March 9, 2024
RVU24AR
$268.85changed to$273.31
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$284.28changed to$268.85
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.51 changed to 7.33
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$295.81changed to$284.28
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.67 changed to 7.51
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$310.12changed to$295.81
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.01 changed to 7.67
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$312.15changed to$310.12
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.77 changed to 8.01
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$315.38changed to$312.15
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.87 changed to 7.77
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$320.08changed to$315.38
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.01 changed to 7.87
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$319.47changed to$320.08
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.02 changed to 8.01
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$318.73changed to$319.47
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$317.94changed to$318.73
- 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.
July 1, 2015
RVU15C
$316.36changed to$317.94
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$312.55changed to$316.36
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$362.89changed to$312.55
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.79 changed to 7.85
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $362.89
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $262.87 | Not available in this setting | RVU26D |
| 2026-07-01 | $262.87 | Not available in this setting | RVU26C |
| 2026-04-01 | $262.87 | Not available in this setting | RVU26B |
| 2026-01-01 | $262.87 | Not available in this setting | RVU26A |
| 2025-10-01 | $259.31 | Not available in this setting | RVU25D |
| 2025-07-01 | $259.31 | Not available in this setting | RVU25C |
| 2025-04-01 | $259.31 | Not available in this setting | RVU25B |
| 2025-01-01 | $259.31 | Not available in this setting | RVU25A |
| 2024-10-01 | $273.31 | Not available in this setting | RVU24D |
| 2024-07-01 | $273.31 | Not available in this setting | RVU24C |
| 2024-04-01 | $273.31 | Not available in this setting | RVU24B |
| 2024-03-09 | $273.31 | Not available in this setting | RVU24AR |
| 2024-01-01 | $268.85 | Not available in this setting | RVU24A |
| 2023-10-01 | $284.28 | Not available in this setting | RVU23D |
| 2023-07-01 | $284.28 | Not available in this setting | RVU23C |
| 2023-04-01 | $284.28 | Not available in this setting | RVU23B |
| 2023-01-01 | $284.28 | Not available in this setting | RVU23A |
| 2022-10-01 | $295.81 | Not available in this setting | RVU22D |
| 2022-07-01 | $295.81 | Not available in this setting | RVU22C |
| 2022-04-01 | $295.81 | Not available in this setting | RVU22B |
| 2022-01-01 | $295.81 | Not available in this setting | RVU22A |
| 2021-10-01 | $310.12 | Not available in this setting | RVU21D |
| 2021-07-01 | $310.12 | Not available in this setting | RVU21C |
| 2021-04-01 | $310.12 | Not available in this setting | RVU21B |
| 2021-01-01 | $310.12 | Not available in this setting | RVU21A |
| 2020-10-01 | $312.15 | Not available in this setting | RVU20D |
| 2020-07-01 | $312.15 | Not available in this setting | RVU20C |
| 2020-04-01 | $312.15 | Not available in this setting | RVU20B |
| 2020-01-01 | $312.15 | Not available in this setting | RVU20A |
| 2019-10-01 | $315.38 | Not available in this setting | RVU19D |
| 2019-07-01 | $315.38 | Not available in this setting | RVU19C |
| 2019-04-01 | $315.38 | Not available in this setting | RVU19B |
| 2019-01-01 | $315.38 | Not available in this setting | RVU19A |
| 2018-10-01 | $320.08 | Not available in this setting | RVU18D |
| 2018-07-01 | $320.08 | Not available in this setting | RVU18C |
| 2018-04-01 | $320.08 | Not available in this setting | RVU18B |
| 2018-01-01 | $320.08 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $319.47 | Not available in this setting | RVU17D |
| 2017-07-01 | $319.47 | Not available in this setting | RVU17C |
| 2017-04-01 | $319.47 | Not available in this setting | RVU17B |
| 2017-01-01 | $319.47 | Not available in this setting | RVU17A |
| 2016-10-01 | $318.73 | Not available in this setting | RVU16D |
| 2016-07-01 | $318.73 | Not available in this setting | RVU16C |
| 2016-04-01 | $318.73 | Not available in this setting | RVU16B |
| 2016-01-01 | $318.73 | Not available in this setting | RVU16A |
| 2015-10-01 | $317.94 | Not available in this setting | RVU15D |
| 2015-07-01 | $317.94 | Not available in this setting | RVU15C |
| 2015-04-01 | $316.36 | Not available in this setting | RVU15B |
| 2015-01-01 | $316.36 | Not available in this setting | RVU15A |
| 2014-10-01 | $312.55 | Not available in this setting | RVU14D |
| 2014-07-01 | $312.55 | Not available in this setting | RVU14C |
| 2014-04-01 | $312.55 | Not available in this setting | RVU14B |
| 2014-01-01 | $312.55 | Not available in this setting | RVU14A |
| 2013-10-01 | $362.89 | Not available in this setting | RVU13D |
| 2013-07-01 | $362.89 | Not available in this setting | RVU13C |
| 2013-04-01 | $362.89 | Not available in this setting | RVU13B |
| 2013-01-01 | $362.89 | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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