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See a sample rate comparisonCPT 78580 Fee Schedule
Medicare rates as of October 2026
CPT 78580 is classified under Radiology Procedures, in the Nuclear Medicine Procedures subgroup.
Lung Scan For Blood Air Flow, A Lung Perfusion Scan Uses A Radioactive Substance To Highlight Blood Flow On Images. A Lung Ventilation Scan May Be Done In The Same Session. It Uses Contrast Material To Produce A Picture Of How Air Is Distributed In The Lungs.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $209.42 national non-facility rate (2026) · View Medicare rates for 78580 |
| Medicaid Fee Schedule | $172.05 median of the 8 states in the free preview · View Medicaid rates for 78580 |
National average reimbursement for CPT 78580 by major payers:
$259.05
BCBS / Anthem
$262.35
UnitedHealthcare
$279.36
Aetna
$319.17
Cigna
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CPT 78580
5 of 25 sample ratesHigher to lower in this preview
David Chmielecki
Northern Arizona Healthcare Corporation
$341.39Published rateJulie Webster
Musc Community Physicians
$308.39Published rateJulie Webster
Musc Community Physicians
$245.83Published rateCarolina Radiology Associates LLC
Carolina Radiology Associates, LLC
$67.91Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$32.61Published rate
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See a sample payer proposalCPT 78580 vs. Other Nuclear Medicine Procedures Codes
The table lists codes related to 78580. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 78579-CPT | Moderate | Lung Scan For Air Flow, A Lung Perfusion Scan Uses An Inhaled Radioactive Substance To View How Air Is Distributed In The Lungs. |
| 78580-CPT | Moderate | Lung Scan For Blood Air Flow, A Lung Perfusion Scan Uses A Radioactive Substance To Highlight Blood Flow On Images. A Lung Ventilation Scan May Be Done In The Same Session. It Uses Contrast Material To Produce A Picture Of How Air Is Distributed In The Lungs. |
| 78582-CPT | Moderate | Pulmonary Ventilation (Eg Aerosol Or Gas) And Perfusion Imaging (Reinstated Code Former Description Was: Nuclear Scan Of Lung;Gaseous With Ventilation Rebreathing And Washout) |
| 78597-CPT | Moderate | Scan Of Lung Function, A Radioactive Substance Is Given By Mouth Or Iv. This Highlights Air And Blood Flow On A Scan So That Lung Function May Be Viewed More Easily. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78580 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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