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See a sample rate comparisonCPT 78597 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78597 |
| Medicaid Fee Schedule | View Medicaid rates for 78597 |
National average reimbursement for CPT 78597 by major payers:
$239.83
$238.44
$232.98
$297.28
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CPT 78597
5 of 25 sample ratesHigher to lower in this preview
Matthew Lilley
Bend Memorial Clinic, PC
$583.17Published rateMarlou Heiland
Northern Arizona Healthcare Corporation
$346.79Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$200.33Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$112.44Published rateAlaric Lebaron
Northern Arizona Healthcare Corporation
$60.59Published rate
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See a sample payer proposalCPT 78597 vs. Other Nuclear Medicine Procedures Codes
The CPT 78597 code is part of the Radiology Procedures services used for Nuclear Medicine Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 78597 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| 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 78597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78597 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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