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CPT 78597 Fee Schedule

Last Verified: December 2025

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.

Quantitative Differential Pulmonary Perfusion, Including Imaging When Performed.
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 78597 by major payers:

bcbs

$239.83

uhc

$238.44

aetna

$232.98

cigna

$303.72

Preview provider-level rates for...
For billing codeCPT 78597
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 78597

United
78597$200.331295728186 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
78597$147.391891774519 - LEON HOME HEALTH, LLC, LEON AT HOME261288029FLHome Health Agency (251E00000X)
United
78597$60.591952324170 - NAVJOT SINGH742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONFLGastroenterology Physician (207RG0100X)
United
78597$346.791306040258 - DEREK FEUQUAY742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZHospitalist Physician (208M00000X)
United
78597$177.191780941286 - MEGHAN HUGHES742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZFamily Medicine Physician (207Q00000X)
United
78597$30.681336551803 - KRISTI ANDREASSEN GUY742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZPhysical Therapist (225100000X)
United
78597$176.081760801823 - SAMUEL WEIMER742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZSurgery Physician (208600000X)
United
78597$286.191326066648 - RICHARD MONTGOMERY742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONKYSurgery Physician (208600000X)
United
78597$145.391417908112 - CHRISTINE MCGREGOR742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZNurse Practitioner (363L00000X)
United
78597$60.591912014515 - MICHELLE EISENBERGER742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONCOCertified Registered Nurse Anesthetist (367500000X)
United
78597$60.591649237678 - ANITA EISENHART742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONNYEmergency Medicine Physician (207P00000X)
United
78597$531.441861933954 - SABRA DIXON751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXPhysician Assistant (363A00000X)
United
78597$623.961487244778 - HEALTH IMAGING PARTNERS, LLC271385885TXPhysiological Laboratory (293D00000X)
United
78597$286.191376984377 - IOANA IRIME742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZEmergency Medicine Physician (207P00000X)
United
78597$176.081982678322 - ZOHREH KAZEMI-DUNN742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZObstetrics & Gynecology Physician (207V00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
78579-CPTModeratePulmonary Ventilation Imaging (Eg, Aerosol Or Gas)
78580-CPTModerateNuclear Medicine Study Of Blood Circulation In The Lungs
78582-CPTModeratePulmonary Ventilation (Eg Aerosol Or Gas) And Perfusion Imaging (Reinstated Code Former Description Was: Nuclear Scan Of Lung;Gaseous With Ventilation Rebreathing And Washout)
78597-CPTModerateQuantitative Differential Pulmonary Perfusion, Including Imaging When Performed.

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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