$194.71
Choose 78580 for lung perfusion imaging, which evaluates pulmonary blood-flow distribution. This code is for inhaled-tracer ventilation imaging.
On this page
CMS RVU26D · Effective 2026-10-01
78579 Lung scan Medicare reimbursement rates in Indiana
Reports nuclear medicine imaging of inhaled tracer distribution in the lungs, commonly as the ventilation portion of an evaluation for suspected pulmonary embolism. Compare 78579 office and facility rates across CMS payment localities in Indiana.
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 78579 in Indiana?
Indiana 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
$154.48
1 of 1 localities have a supported rate.
Payment area: Indiana
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 78579: Lung ventilation imaging
Reports nuclear medicine imaging of inhaled tracer distribution in the lungs, commonly as the ventilation portion of an evaluation for suspected pulmonary embolism.
A lung ventilation study uses inhaled radioactive gas or aerosol to show how air and tracer distribute through the lungs. A nuclear medicine technologist typically acquires the images in a hospital or imaging department, with a radiologist or nuclear medicine physician interpreting them. The study is often part of an evaluation for suspected pulmonary embolism, where ventilation findings may be considered alongside lung perfusion imaging.
Report this code when the service performed is ventilation imaging, rather than a combined ventilation-and-perfusion study. The record should support the ventilation procedure performed and the resulting interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither modifier for the global service. These components are separately priced in the Medicare fee schedule.
CMS billing rules for 78579
- 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 RVU0.48 · 10%
- Practice expense (office) RVU4.44 · 89%
- Malpractice RVU0.06 · 1%
205
Medicare services in 2024 · #4311 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.
78579 compared with similar codes
Office rates for Indiana, from the same CMS release.
$270.29
Choose 78582 when both ventilation and perfusion imaging are performed as a combined study; 78579 describes ventilation imaging alone.
$246.23
78598 is for differential ventilation and perfusion imaging. Use 78579 for ventilation imaging that is not reported as that differential study.
Compare 78579 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
Indiana →
Office / nonfacility
$154.48
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 78579 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
9,425
- Code
- 78579
- Physician work
- 0.48
- Practice expense
- 4.44
- Malpractice
- 0.06
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.000 | 0.4800 |
| Practice expense | 4.44 | × 0.927 | 4.1159 |
| Malpractice | 0.06 | × 0.486 | 0.0292 |
| Total RVUs | 4.6250 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$154.48
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.48 | 1 |
| Practice expense | 4.44 | 0.927 |
| Malpractice | 0.06 | 0.486 |
(0.48 × 1 + 4.44 × 0.927 + 0.06 × 0.486) × $33.4009 = $154.48
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.
78579 billing questions
How is this different from 78582?
78579 represents ventilation imaging alone. Use 78582 when the performed study includes both ventilation and perfusion imaging.
When would 78580 be used instead?
78580 represents lung perfusion imaging. It is the relevant code when the imaging evaluates tracer distribution in pulmonary blood flow rather than inhaled ventilation.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Submit without either modifier for the global service.
What documentation supports reporting 78579?
Document that ventilation imaging was performed, the inhaled tracer study acquired, and the interpretation. The record should distinguish a ventilation-only service from combined ventilation and perfusion imaging.
Can ventilation imaging be billed with perfusion imaging?
When both components are performed as a combined ventilation-and-perfusion study, 78582 describes that combined service. Do not treat 78579 as the code for the combined examination.
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.
9,42278499,,Unlisted cv 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
9,42378499,26,Unlisted cv px dx nuc med,C,,0.00,0.00,,0.00,,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
9,42478499,TC,Unlisted cv 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
9,42578579,,Lung ventilation imaging,A,,0.48,4.44,,4.44,NA,0.06,4.98,4.98,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.30,12.30,0.12
9,42678579,26,Lung ventilation imaging,A,,0.48,0.16,,0.16,,0.03,0.67,0.67,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,42778579,TC,Lung ventilation imaging,A,,0.00,4.28,,4.28,NA,0.03,4.31,4.31,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.14,12.14,0.09
9,42878580,,Lung perfusion imaging,A,,0.72,5.47,,5.47,NA,0.08,6.27,6.27,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,12.38,12.38,0.13
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915