$257.47
Choose 78582 for a combined ventilation-perfusion examination without differential measurements. Choose 78598 when the completed examination measures the regional distribution of both.
On this page
CMS RVU26D · Effective 2026-10-01
78598 Lung V/Q imaging Medicare reimbursement rates in Alabama
Reports a nuclear medicine study measuring the relative ventilation and perfusion of lung regions, often for preoperative assessment of remaining lung function. Compare 78598 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 78598 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$234.30
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Nuclear medicine
About 78598: Differential lung ventilation and perfusion imaging
Reports a nuclear medicine study measuring the relative ventilation and perfusion of lung regions, often for preoperative assessment of remaining lung function.
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.
CMS billing rules for 78598
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.83 · 10%
- Practice expense (office) RVU7.01 · 88%
- Malpractice RVU0.09 · 1%
1.3K
Medicare services in 2024 · #2765 by national volume
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.
78598 compared with similar codes
Office rates for Alabama, from the same CMS release.
$159.96
78597 measures differential perfusion. 78598 requires the combined differential ventilation and perfusion examination.
$185.43
78580 covers perfusion imaging alone. It does not represent an examination that also measures differential ventilation.
Compare 78598 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$234.30
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 78598 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
9,437
- Code
- 78598
- Physician work
- 0.83
- Practice expense
- 7.01
- Malpractice
- 0.09
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 7.01 | × 0.875 | 6.1338 |
| Malpractice | 0.09 | × 0.566 | 0.0509 |
| Total RVUs | 7.0147 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$234.30
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1 |
| Practice expense | 7.01 | 0.875 |
| Malpractice | 0.09 | 0.566 |
(0.83 × 1 + 7.01 × 0.875 + 0.09 × 0.566) × $33.4009 = $234.30
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
9,43478597,,Lung perfusion differential,A,,0.73,4.60,,4.60,NA,0.06,5.39,5.39,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.37,12.37,0.11
9,43578597,26,Lung perfusion differential,A,,0.73,0.23,,0.23,,0.03,0.99,0.99,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,43678597,TC,Lung perfusion differential,A,,0.00,4.37,,4.37,NA,0.03,4.40,4.40,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.14,12.14,0.08
9,43778598,,Lung perf&ventilat diferentl,A,,0.83,7.01,,7.01,NA,0.09,7.93,7.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.75,16.75,0.16
9,43878598,26,Lung perf&ventilat diferentl,A,,0.83,0.26,,0.26,,0.04,1.13,1.13,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,43978598,TC,Lung perf&ventilat diferentl,A,,0.00,6.75,,6.75,NA,0.05,6.80,6.80,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.49,16.49,0.12
9,44078599,,Unlisted resp px dx nuc med,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515