$153.52
78457 represents a single-side venous thrombosis imaging study; 78458 represents bilateral imaging and is priced accordingly.
On this page
CMS RVU26D · Effective 2026-10-01
78458 Venous imaging Medicare reimbursement rates in Tennessee
Bilateral venous thrombosis imaging evaluates venous flow and possible thrombus in both sides when a nuclear medicine study is performed. Compare 78458 office and facility rates across CMS payment localities in Tennessee.
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 78458 in Tennessee?
Tennessee 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
$170.67
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 78458: Bilateral venous thrombosis imaging
Bilateral venous thrombosis imaging evaluates venous flow and possible thrombus in both sides when a nuclear medicine study is performed.
This nuclear medicine study images venous flow and possible thrombus on both sides, commonly in the lower extremities when bilateral venous thrombosis is being evaluated. A nuclear medicine or radiology physician interprets the images; the technical service involves the equipment and staff used to perform the study. The report should identify the areas examined and document the interpretation of the bilateral findings.
Report 78458 when the service performed is bilateral venous thrombosis imaging, rather than a single-side study. The code is already priced as bilateral, so modifier 50 does not increase payment. Bill the global service without a component modifier, or separate the interpretation with modifier 26 and the technical service with modifier TC. When the cardiovascular diagnostic multiple procedure reduction applies, it affects the technical component. Documentation should support that both sides were imaged and include the interpreting physician’s findings.
CMS billing rules for 78458
- 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.
- Multiple procedures
- Cardiovascular diagnostic multiple procedure reduction applies to the technical component.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.88 · 16%
- Practice expense (office) RVU4.60 · 83%
- Malpractice RVU0.09 · 2%
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.
78458 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$260.36
78456 is identified for acute venous thrombus imaging. Select 78458 when the documented service is bilateral venous thrombosis imaging.
$168.24
93970 reports bilateral extremity venous duplex ultrasound, not nuclear medicine venous thrombosis imaging.
Compare 78458 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
Tennessee →
Office / nonfacility
$170.67
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 78458 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
9,383
- Code
- 78458
- Physician work
- 0.88
- Practice expense
- 4.60
- Malpractice
- 0.09
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.88 | × 1.000 | 0.8800 |
| Practice expense | 4.60 | × 0.909 | 4.1814 |
| Malpractice | 0.09 | × 0.537 | 0.0483 |
| Total RVUs | 5.1097 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$170.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.88 | 1 |
| Practice expense | 4.6 | 0.909 |
| Malpractice | 0.09 | 0.537 |
(0.88 × 1 + 4.6 × 0.909 + 0.09 × 0.537) × $33.4009 = $170.67
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.
78458 billing questions
When should 78458 be chosen over 78457?
Use 78458 for a bilateral venous thrombosis imaging study. Use 78457 when the study is for a single side.
Should modifier 50 be appended for a bilateral study?
No. 78458 is priced as bilateral, and modifier 50 does not increase payment.
Can the interpretation and technical service be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical service. Without either modifier, the claim represents the global service.
Which part of the service is subject to the multiple procedure reduction?
The cardiovascular diagnostic multiple procedure reduction applies to the technical component. It does not change the component designation of the professional interpretation.
What documentation supports reporting 78458?
Document that the bilateral study was performed, which areas were imaged, and the interpreting physician’s findings. The record should support bilateral rather than single-side imaging.
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.
9,38078457,,Venous thrombosis imaging,A,,0.75,4.19,,4.19,NA,0.07,5.01,5.01,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,16.72,16.72,0.20
9,38178457,26,Venous thrombosis imaging,A,,0.75,0.28,,0.28,,0.03,1.06,1.06,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,38278457,TC,Venous thrombosis imaging,A,,0.00,3.91,,3.91,NA,0.04,3.95,3.95,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,16.44,16.44,0.17
9,38378458,,Ven thrombosis images bilat,A,,0.88,4.60,,4.60,NA,0.09,5.57,5.57,1,XXX,0.00,0.00,0.00,6,2,0,0,0,9,,33.4009,09,0,99,12.43,12.43,0.16
9,38478458,26,Ven thrombosis images bilat,A,,0.88,0.32,,0.32,,0.05,1.25,1.25,1,XXX,0.00,0.00,0.00,6,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,38578458,TC,Ven thrombosis images bilat,A,,0.00,4.28,,4.28,NA,0.04,4.32,4.32,1,XXX,0.00,0.00,0.00,6,2,0,0,0,9,,33.4009,01,0,99,12.11,12.11,0.11
9,38678459,,Myocrd img pet single study,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,,33.4009,09,0,99,40.08,40.08,0.07
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780