Billing code 78580: Lung perfusion scanMedicare rate & RVUs in Oregon
Reports nuclear medicine imaging of pulmonary blood flow when a perfusion-only lung study is performed, including evaluation for suspected pulmonary embolism.
Medicare pays $207.90–$229.40 for 78580 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.
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 9 sections
What 78580 covers
This nuclear medicine study maps blood flow through the lungs after intravenous administration of radiolabeled particles. Gamma-camera images show how perfusion is distributed across the lungs. Common reasons include suspected pulmonary embolism, assessment of pulmonary vascular perfusion, and evaluation of functioning lung before selected thoracic surgery. A nuclear medicine technologist acquires the images, which a radiologist or nuclear medicine physician interprets in a hospital or outpatient imaging setting.
Report 78580 for perfusion imaging alone. When ventilation and perfusion imaging are both performed, 78582 describes the combined examination. Documentation should support the clinical indication, radiopharmaceutical administration, images obtained, and interpretation. The service has separately priced professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
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.
Where 78580 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $229.40 | Unavailable |
| Rest Of Oregon | $207.90 | Unavailable |
How the 78580 rate is calculated
Each of 78580’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 · 78580
RVUs × geographic indexes × conversion factor
Work0.72
0.72 RVUs× 1.000 GPCI
Practice expense5.47
5.47 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
6.2700
Conversion factor
$33.4009
Medicare rate
$209.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78580
The CMS indicators that decide how 78580 is paid alongside other services.
CMS payment indicators · 78580
Lung perfusion scan
| 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
78580 without 26 · national office
$209.42
Lung perfusion scan
78580-26 · Professional component
$33.73
Pays only the interpretation and report.
78580 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78579Lung scan
- 78579 reports lung ventilation imaging. Choose 78580 when the study images pulmonary blood flow rather than ventilation.
- 78582Lung scan
- 78582 describes both ventilation and perfusion imaging in the combined examination. Use 78580 when only perfusion imaging is performed.
- 78597Lung perfusion
- 78597 is for quantitative differential pulmonary perfusion imaging; 78580 reports perfusion imaging without that quantitative differential service.
- 78598Lung V/Q imaging
- 78598 describes combined ventilation and perfusion imaging with quantitative differential assessment. It is distinct from perfusion-only imaging reported with 78580.
78580 billing questions
When should 78580 be reported instead of 78582?
Use 78580 when the examination includes perfusion imaging only. When both ventilation and perfusion imaging are performed, report the combined examination with 78582.
What do modifiers 26 and TC identify?
Modifier 26 identifies the professional interpretation component, and modifier TC identifies the technical component, including equipment and staff. Without either modifier, the claim represents the global service.
Can 78580 be reported with 78579 for a ventilation-perfusion study?
When both ventilation and perfusion imaging are performed as a combined examination, 78582 describes that service. Do not report 78580 as though it represented the entire combined study.
How does 78580 differ from quantitative differential perfusion imaging?
78580 reports perfusion imaging without the quantitative differential study described by 78597. Select the code that matches the service performed and documented.
What documentation supports 78580?
The record should identify the indication, radiopharmaceutical administration, images acquired, and the interpreting clinician's findings. It should also make clear whether the billed service is professional, technical, or global.
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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