$189.28
Choose 78597 when the perfusion study includes differential quantitative analysis. Choose 78580 for particulate-tracer perfusion imaging without that analysis.
On this page
CMS RVU26D · Effective 2026-10-01
78597 Lung perfusion Medicare reimbursement rates in Oklahoma
Reports particulate-tracer lung perfusion imaging with quantitative comparison of pulmonary blood flow, often to assess function before planned lung resection. Compare 78597 office and facility rates across CMS payment localities in Oklahoma.
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 78597 in Oklahoma?
Oklahoma 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
$163.14
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 78597: Differential lung perfusion imaging
Reports particulate-tracer lung perfusion imaging with quantitative comparison of pulmonary blood flow, often to assess function before planned lung resection.
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.
CMS billing rules for 78597
- 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 RVU0.73 · 14%
- Practice expense (office) RVU4.60 · 85%
- Malpractice RVU0.06 · 1%
1.9K
Medicare services in 2024 · #2506 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.
78597 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$239.15
78598 covers differential quantitative assessment of both ventilation and perfusion; 78597 covers differential perfusion imaging only.
$262.79
78582 is a combined ventilation-perfusion study without differential quantification. 78597 is a perfusion-only study with differential quantitative analysis.
Compare 78597 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
Oklahoma →
Office / nonfacility
$163.14
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 78597 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
9,434
- Code
- 78597
- Physician work
- 0.73
- Practice expense
- 4.60
- Malpractice
- 0.06
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 4.60 | × 0.893 | 4.1078 |
| Malpractice | 0.06 | × 0.777 | 0.0466 |
| Total RVUs | 4.8844 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Oklahoma$163.14
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.73 | 1 |
| Practice expense | 4.6 | 0.893 |
| Malpractice | 0.06 | 0.777 |
(0.73 × 1 + 4.6 × 0.893 + 0.06 × 0.777) × $33.4009 = $163.14
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.
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 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.
9,43178582,,Lung ventilat&perfus imaging,A,,1.04,7.55,,7.55,NA,0.11,8.70,8.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.84,16.84,0.18
9,43278582,26,Lung ventilat&perfus imaging,A,,1.04,0.35,,0.35,,0.06,1.45,1.45,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,43378582,TC,Lung ventilat&perfus imaging,A,,0.00,7.20,,7.20,NA,0.05,7.25,7.25,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,16.49,16.49,0.12
9,43478597,,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
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193