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CPT code 78431: Cardiac PET, rest and stress with CT2026 Medicare rate & RVUs

PET myocardial perfusion imaging at rest and stress with concurrently acquired CT is reported for cardiac evaluation using both phases.

CMS RVU26DEffective Oct 1, 2026109 payment localities197.4K Medicare services in 2024

Medicare rate · 78431

Cardiac PET, rest and stress with CT

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 78431 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 78431 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78431 covers

This examination uses PET to assess myocardial perfusion in separate rest and stress acquisitions, with a concurrently acquired CT used for attenuation correction. Stress may be induced by exercise or medication. Nuclear medicine or cardiology imaging teams perform the technical study, and a qualified practitioner interprets the images. This protocol distinguishes the code from a single-study PET examination and from SPECT myocardial perfusion imaging.

Medicare assigns physician fee schedule status C (carrier priced): CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The service has professional and technical portions: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no modifier reports the global service. Report the code for the rest-and-stress PET myocardial perfusion examination with CT.

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 78431 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

78431 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

78431 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
78431 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 78431 rate is calculated

Each of 78431’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 · 78431

RVUs × geographic indexes × conversion factor

Office or facility?

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 78431

The CMS indicators that decide how 78431 is paid alongside other services.

CMS payment indicators · 78431

Cardiac PET, rest and stress with CT

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78431 without 26 · national facility

$0.00

Cardiac PET, rest and stress with CT

78431-26 · Professional component

$86.51

Pays only the interpretation and report.

When to use modifier 26

78431 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 78431

    Cardiac PET, rest and stress with CT0 wRVU

    Not priced

  • 78429

    Cardiac PET, single metabolic study with CT0 wRVU

    Not priced

  • 78430

    Myocardial PET, rest and stress with CT0 wRVU

    Not priced

  • 78451

    Cardiac SPECT, single rest or stress study1.35 wRVU

    $311.30

  • 78452

    Nuclear stress test, SPECT, multiple perfusion studies1.58 wRVU

    $427.87

How to choose

78429Cardiac PETSingle metabolic study with CT
78429 is a single PET study with metabolic evaluation at rest or stress. This code covers rest-and-stress PET myocardial perfusion imaging.
78430Myocardial PETRest and stress with CT
Both codes describe rest-and-stress PET myocardial perfusion imaging with CT. 78431 specifies a concurrently acquired CT for attenuation correction.
78451Cardiac SPECTSingle rest or stress study
78451 is a single-study SPECT myocardial perfusion examination. This code is a rest-and-stress PET examination with concurrently acquired CT.
78452Nuclear stress testSPECT, multiple perfusion studies
78452 is multiple-study SPECT myocardial perfusion imaging. This code is the PET rest-and-stress examination with concurrently acquired CT.

Codes related to 78431

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 78431
CodeHow it relatesNational office range
Same family
78430Myocardial PET, rest and stress with CTRest-and-stress PET sibling; 78431 specifies concurrently acquired CT attenuation correction.No office rate
78429Cardiac PET, single metabolic study with CTSingle-study PET sibling with metabolic evaluation, rather than rest-and-stress imaging.No office rate
78432Myocardial PET, two radiopharmaceuticalsTwo-radiotracer PET myocardial imaging sibling.No office rate
78433Myocardial PET, two radiopharmaceuticalsTwo-radiotracer PET myocardial imaging sibling with CT.No office rate
Used instead
78451Cardiac SPECT, single rest or stress studySPECT myocardial perfusion imaging for a single study.$272.61–$430.89
78452Nuclear stress test, SPECT, multiple perfusion studiesSPECT myocardial perfusion imaging for multiple studies.$373.48–$595.53

78431 billing questions

When should this code be used instead of a SPECT cardiac study?

Use this code for rest-and-stress myocardial perfusion imaging performed with PET and concurrently acquired CT. SPECT myocardial perfusion studies are reported with codes such as 78451 or 78452, depending on the study.

Does this code include both rest and stress imaging?

Yes. It represents PET myocardial perfusion imaging at rest and under exercise or pharmacologic stress, with concurrently acquired CT for attenuation correction.

How should the professional and technical portions be reported?

Append modifier 26 for the professional interpretation or modifier TC for the technical portion. Report the global service without either modifier.

Does Medicare publish a national payment for this code?

No. Its physician fee schedule status is C, meaning the Medicare Administrative Contractor sets payment for each claim.

How does this differ from 78429?

Code 78429 describes a single PET study with metabolic evaluation at rest or stress. This code represents PET myocardial perfusion imaging at both rest and stress.

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

Open CMS sourceHow we calculate rates

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