CPT code 78430: Myocardial PET, rest and stress with CT2026 Medicare rate & RVUs in New York
Reports myocardial PET imaging at rest and stress with CT when both conditions are evaluated in a cardiac perfusion study.
CMS doesn’t publish an office rate for 78430 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 78430 covers
This cardiac imaging study uses positron emission tomography to evaluate the myocardium at rest and under stress, with CT imaging acquired as part of the service. It is reported for a combined rest-and-stress PET examination. Imaging staff perform the technical acquisition, and a physician may report the professional interpretation.
Medicare assigns this code physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The service has professional and technical components. Modifier 26 identifies the professional interpretation, modifier TC identifies the technical service, and reporting the code without either modifier represents the global service. This is the rest-and-stress study, distinct from a single-study PET service.
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.
Where 78430 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
How the 78430 rate is calculated
Each of 78430’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 78430
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78430
The CMS indicators that decide how 78430 is paid alongside other services.
CMS payment indicators · 78430
Myocardial PET, rest and stress with CT
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
78430 without 26 · national facility
$0.00
Myocardial PET, rest and stress with CT
78430-26 · Professional component
$74.15
Pays only the interpretation and report.
78430 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78429Cardiac PETSingle metabolic study with CT
- 78429 describes a single PET study at rest or stress with CT. 78430 describes PET imaging at rest and stress with CT.
- 78451Cardiac SPECTSingle rest or stress study
- 78451 describes myocardial imaging by SPECT. 78430 describes PET imaging with CT at rest and stress.
- 78452Nuclear stress testSPECT, multiple perfusion studies
- 78452 describes multiple-study myocardial imaging by SPECT. 78430 describes rest-and-stress PET imaging with CT.
- 78491Myocardial PETSingle study
- 78491 describes a single myocardial PET study. 78430 describes rest-and-stress PET imaging with CT.
78430 billing questions
When should 78430 be selected instead of 78429?
78430 describes myocardial PET imaging at rest and stress with CT. 78429 describes a single PET study at rest or stress with CT.
How are the professional and technical services reported?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the code represents the global service.
Does Medicare publish a national payment amount for 78430?
No. Its physician fee schedule status is carrier priced, so the Medicare Administrative Contractor sets payment for each claim.
How does 78430 differ from myocardial SPECT imaging?
78430 describes PET imaging with CT at rest and stress. Codes 78451 and 78452 describe myocardial imaging by SPECT.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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