CPT code 78433: Myocardial PET, two radiopharmaceuticals2026 Medicare rate & RVUs in Maryland
This myocardial PET examination uses two radiopharmaceuticals with CT and is reported for multiple studies at rest and/or stress, with optional blood-flow quantification.
CMS doesn’t publish an office rate for 78433 in Maryland.
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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On this page 9 sections
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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
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.
How the rate is built · 78433
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 78433
The CMS indicators that decide how 78433 is paid alongside other services.
CMS payment indicators · 78433
Myocardial PET, two radiopharmaceuticals
| 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
78433 without 26 · national facility
$0.00
Myocardial PET, two radiopharmaceuticals
78433-26 · Professional component
$100.20
Pays only the interpretation and report.
78433 compared with similar codes
Compare codes · National
4 codes, side by side
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.
78433 billing questions
What type of myocardial PET protocol does 78433 describe?
It describes multiple myocardial PET studies at rest and/or stress using two radiopharmaceuticals, with a CT transmission acquisition. Blood-flow quantification may also be performed.
How does 78433 differ from 78432?
Both codes describe myocardial PET using two radiopharmaceuticals. Code 78433 includes CT, while 78432 does not.
How does 78433 differ from 78431?
Code 78431 describes myocardial PET at rest and stress with CT. Code 78433 identifies the protocol using two radiopharmaceuticals.
Can the interpretation and technical work be reported separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion. Reporting without either modifier represents the global service.
How does Medicare price this code?
Its physician fee schedule status is C, or carrier priced. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.
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.
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