CPT code 78433: Myocardial PET, two radiopharmaceuticals2026 Medicare rate & RVUs

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

What 78433 covers

This study uses PET to assess the myocardium with two radiopharmaceuticals and multiple acquisitions at rest and/or stress. A CT transmission acquisition accompanies the PET examination for attenuation correction and anatomical localization; myocardial blood-flow quantification may also be performed. Nuclear medicine or cardiology clinicians interpret the examination, while imaging facilities provide the PET/CT equipment and technical acquisition.

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 code has professional and technical portions. Modifier 26 reports the interpretation, modifier TC reports the technical portion, and reporting without either modifier represents the global service. It distinguishes a two-radiopharmaceutical PET protocol with CT from 78432, which lacks the CT acquisition, and from the rest-and-stress protocol described by 78431.

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 78433 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

78433 rates by state

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

How the 78433 rate is calculated

Each of 78433’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.

Payment rules and modifiers for 78433

The CMS indicators that decide how 78433 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78433 compared with similar codes

How to choose

78432Myocardial PETTwo radiopharmaceuticals

Both describe myocardial PET using two radiopharmaceuticals. Use 78433 when the examination includes CT; 78432 is the corresponding option without CT.

78431Cardiac PETRest and stress with CT

Code 78431 describes myocardial PET with CT at rest and stress. Code 78433 identifies the protocol using two radiopharmaceuticals.

78452Nuclear stress testSPECT, multiple perfusion studies

Code 78452 describes myocardial perfusion imaging with SPECT. Code 78433 describes myocardial PET using two radiopharmaceuticals with CT.

Codes related to 78433

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

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