CPT 78579
Global XXX ActiveLung ventilation imaging
CPT 78579 Billing & Documentation Guide
CPT code 78579 (Lung ventilation imaging) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.48, a non-facility practice expense RVU of 4.44, and a malpractice RVU of 0.06, a total non-facility RVU of 4.98 and facility RVU of 4.98. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $172.85, though rates vary from $144.45 to $232.72 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78579, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 78579 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 78579 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 78579
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.48 | 0.48 |
| Practice Expense RVU | 4.44 | 4.44 |
| Malpractice RVU | 0.06 | 0.06 |
| Total RVU | 4.98 | 4.98 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78579
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $193.18 | $193.18 | $179.92 - $232.72 | 29 |
| Florida | $168.73 | $168.73 | $160.82 - $175.48 | 3 |
| Georgia | $159.93 | $159.93 | $150.7 - $169.16 | 2 |
| Illinois | $163.21 | $163.21 | $154.56 - $172 | 4 |
| Michigan | $158.11 | $158.11 | $153.69 - $162.52 | 2 |
| North Carolina | $155.68 | $155.68 | $155.68 - $155.68 | 1 |
| New York | $184.96 | $184.96 | $158.33 - $197.11 | 5 |
| Ohio | $153.45 | $153.45 | $153.45 - $153.45 | 1 |
| Pennsylvania | $163.58 | $163.58 | $154.07 - $173.09 | 2 |
| Texas | $163.98 | $163.98 | $152.85 - $174.74 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 78579
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78579 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 76000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 78579
What does CPT code 78579 mean? +
CPT code 78579 represents: Lung ventilation imaging. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78579? +
The 2026 Medicare national average non-facility payment for CPT 78579 is $172.85. Rates range from $144.45 to $232.72 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78579? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 78579? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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