$171.32
78579 reports lung ventilation imaging. Choose 78580 when the study images pulmonary blood flow rather than ventilation.
On this page
CMS RVU26D · Effective 2026-10-01
78580 Lung perfusion scan Medicare reimbursement rates in Rhode Island
Reports nuclear medicine imaging of pulmonary blood flow when a perfusion-only lung study is performed, including evaluation for suspected pulmonary embolism. Compare 78580 office and facility rates across CMS payment localities in Rhode Island.
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 78580 in Rhode Island?
Rhode Island 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
$215.62
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 78580: Pulmonary perfusion imaging
Reports nuclear medicine imaging of pulmonary blood flow when a perfusion-only lung study is performed, including evaluation for suspected pulmonary embolism.
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.
CMS billing rules for 78580
- 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 RVU0.72 · 11%
- Practice expense (office) RVU5.47 · 87%
- Malpractice RVU0.08 · 1%
31.4K
Medicare services in 2024 · #957 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.
78580 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$299.17
78582 describes both ventilation and perfusion imaging in the combined examination. Use 78580 when only perfusion imaging is performed.
$185.35
78597 is for quantitative differential pulmonary perfusion imaging; 78580 reports perfusion imaging without that quantitative differential service.
$272.80
78598 describes combined ventilation and perfusion imaging with quantitative differential assessment. It is distinct from perfusion-only imaging reported with 78580.
Compare 78580 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
Rhode Island →
Office / nonfacility
$215.62
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 78580 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
9,428
- Code
- 78580
- Physician work
- 0.72
- Practice expense
- 5.47
- Malpractice
- 0.08
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.72 | × 1.019 | 0.7337 |
| Practice expense | 5.47 | × 1.033 | 5.6505 |
| Malpractice | 0.08 | × 0.892 | 0.0714 |
| Total RVUs | 6.4555 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$215.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.72 | 1.019 |
| Practice expense | 5.47 | 1.033 |
| Malpractice | 0.08 | 0.892 |
(0.72 × 1.019 + 5.47 × 1.033 + 0.08 × 0.892) × $33.4009 = $215.62
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.
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 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.
9,42578579,,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
9,42978580,26,Lung perfusion imaging,A,,0.72,0.25,,0.25,,0.04,1.01,1.01,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,43078580,TC,Lung perfusion imaging,A,,0.00,5.22,,5.22,NA,0.04,5.26,5.26,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,12.13,12.13,0.09
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537