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CPT code 78451: Cardiac SPECT, single rest or stress study2026 Medicare rate & RVUs in Queens, NY

Reports one SPECT myocardial perfusion study at rest or stress to assess blood flow to the heart muscle in suspected or known coronary disease.

CMS RVU26DEffective Oct 1, 2026One payment locality20.3K Medicare services in 2024

In Queens, NY, Medicare pays $363.50 for 78451 in the office.

$363.50Office (non-facility)
Not available in this settingHospital or facility
+16.8%vs the national office rate ($311.30)

Check a contract rate as a % of Medicare · 78451 nationwide

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

We’ll open 78451 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 78451 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 78451 covers

This service uses a radiopharmaceutical and a gamma camera to create tomographic images of myocardial perfusion for one study, performed at rest or under exercise or pharmacologic stress. Cardiologists, nuclear medicine physicians, and radiologists may interpret the images in hospital or outpatient imaging settings. Clinicians commonly use the study to evaluate suspected or established coronary artery disease and possible ischemia or prior myocardial injury.

Report 78451 for a single rest or stress study; when both rest and stress studies are performed, 78452 is the related SPECT code. Documentation should identify the study condition and support the imaging and interpretation performed. The code has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component.

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.

How Queens, NY compares for 78451

Across 109 of 109 payment localities, the office rate for 78451 runs from $272.61 in Arkansas to $430.89 in San Benito County, CA. Queens, NY pays $363.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

78451 in Queens, NY vs other payment areas
  1. Queens, NY · this page$363.50
  2. Manhattan, NY · New York$358.72−$4.78
  3. NYC suburbs and Long Island, NY · New York$366.73+$3.23
  4. Poughkeepsie and northern NYC suburbs, NY · New York$339.00−$24.50
  5. Rest of New York · New York$297.16−$66.34
  6. Los Angeles, CA · California$360.13−$3.37
  7. Washington, DC area · District of Columbia$360.90−$2.60

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

78451 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$327.18—
Chicago, ILIllinois$317.25—
AlaskaAlaska$349.43—
AlabamaAlabama$276.99—
ArkansasArkansas$272.61—
ArizonaArizona$302.67—
Bakersfield, CACalifornia$336.08—
Chico, CACalifornia$335.75—

78451 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.

$272.61

$383.32

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
78451 office rate range by state
State / territoryOffice rate rangeLocalities
AK$349.431
AL$276.991
AR$272.611
AZ$302.671
CA$335.75–$430.8929
CO$327.931
CT$333.141
DC$360.901
DE$308.031
FL$301.41–$327.183
GA$283.55–$316.312
GU$345.901
HI$345.901
IA$286.941
ID$288.511
IL$290.31–$321.294
IN$290.391
KS$284.401
KY$281.831
LA$280.93–$296.242
MA$325.27–$363.772
MD$314.63–$360.903
ME$289.00–$307.702
MI$288.86–$304.392
MN$316.571
MO$274.93–$298.693
MS$273.891
MT$311.291
NC$292.481
ND$309.311
NE$288.981
NH$321.661
NJ$337.61–$356.422
NM$290.151
NV$311.001
NY$297.16–$366.735
OH$288.451
OK$282.421
OR$309.25–$340.342
PA$289.56–$323.532
PR$314.141
RI$320.471
SC$290.821
SD$309.081
TN$285.831
TX$287.40–$326.258
UT$295.181
VA$305.85–$360.902
VI$314.141
VT$307.021
WA$325.02–$372.612
WI$297.941
WV$278.301
WY$310.431

See 78451 in every payment locality

How the 78451 rate is calculated

Each of 78451’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 · 78451

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.35

1.35 RVUs× 1.000 GPCI

Practice expense7.87

7.87 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

9.3200

Conversion factor

$33.4009

Medicare rate

$311.30

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,365

Code
78451
Physician work
1.35
Practice expense
7.87
Malpractice
0.10

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 78451 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.35× 1.0641.4364
Practice expense7.87× 1.1829.3023
Malpractice0.10× 1.4420.1442
Total RVUs10.8829
Conversion factor× 33.4009

Office rate, Queens, NY$363.50

Office: (1.35 × 1.064 + 7.87 × 1.182 + 0.1 × 1.442) × $33.4009 = $363.50

Open 78451 in the RVU calculator

Payment rules and modifiers for 78451

The CMS indicators that decide how 78451 is paid alongside other services.

CMS payment indicators · 78451

Cardiac SPECT, single rest or stress study

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures6Diagnostic cardiovascular reduction applies to the technical component.
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

78451 without 26 · national office

$311.30

Cardiac SPECT, single rest or stress study

78451-26 · Professional component

$63.13

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78451

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

Codes related to 78451
CodeHow it relatesOffice range, Queens, NY
Same family
78452Nuclear stress test, SPECT, multiple perfusion studiesSPECT myocardial perfusion code for multiple studies, such as rest and stress.$500.64
Used instead
78453Heart perfusion imaging, single planar studySingle-study myocardial perfusion imaging using planar rather than tomographic imaging.$307.71
78454Heart imaging, multiple planar studiesMultiple-study myocardial perfusion imaging using planar rather than tomographic imaging.$447.70
78491Myocardial PET, single studyMyocardial perfusion imaging by PET rather than SPECT.No office rate

How 78451 has changed in Queens, NY

78451 · Office / nonfacility

$363.50

Effective 2026-10-01

The base rate is $13.77 higher than on 2025-10-01, moving from $349.73 to $363.50 (3.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $349.73changed to$363.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.38 changed to 1.35
    • Practice expense RVU 7.72 changed to 7.87
    • Malpractice RVU 0.08 changed to 0.10
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $368.44changed to$349.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.91 changed to 7.72
    • Malpractice RVU 0.10 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $362.42changed to$368.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $383.36changed to$362.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.99 changed to 7.91
    • Malpractice RVU 0.08 changed to 0.10
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $405.99changed to$383.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.15 changed to 7.99
    • Malpractice RVU 0.10 changed to 0.08
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $425.63changed to$405.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.53 changed to 8.15

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $418.20changed to$425.63

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.15 changed to 8.53
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $418.48changed to$418.20

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.29 changed to 8.15
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $427.09changed to$418.48

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.50 changed to 8.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $423.30changed to$427.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.44 changed to 8.50
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $422.97changed to$423.30

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.46 changed to 8.44
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $422.42changed to$422.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.43 changed to 8.46
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $420.32changed to$422.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $414.70changed to$420.32

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.33 changed to 8.43
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $425.12changed to$414.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.13 changed to 8.33
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $425.12

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$363.50Not available in this settingRVU26D
2026-07-01$363.50Not available in this settingRVU26C
2026-04-01$363.50Not available in this settingRVU26B
2026-01-01$363.50Not available in this settingRVU26A
2025-10-01$349.73Not available in this settingRVU25D
2025-07-01$349.73Not available in this settingRVU25C
2025-04-01$349.73Not available in this settingRVU25B
2025-01-01$349.73Not available in this settingRVU25A
2024-10-01$368.44Not available in this settingRVU24D
2024-07-01$368.44Not available in this settingRVU24C
2024-04-01$368.44Not available in this settingRVU24B
2024-03-09$368.44Not available in this settingRVU24AR
2024-01-01$362.42Not available in this settingRVU24A
2023-10-01$383.36Not available in this settingRVU23D
2023-07-01$383.36Not available in this settingRVU23C
2023-04-01$383.36Not available in this settingRVU23B
2023-01-01$383.36Not available in this settingRVU23A
2022-10-01$405.99Not available in this settingRVU22D
2022-07-01$405.99Not available in this settingRVU22C
2022-04-01$405.99Not available in this settingRVU22B
2022-01-01$405.99Not available in this settingRVU22A
2021-10-01$425.63Not available in this settingRVU21D
2021-07-01$425.63Not available in this settingRVU21C
2021-04-01$425.63Not available in this settingRVU21B
2021-01-01$425.63Not available in this settingRVU21A
2020-10-01$418.20Not available in this settingRVU20D
2020-07-01$418.20Not available in this settingRVU20C
2020-04-01$418.20Not available in this settingRVU20B
2020-01-01$418.20Not available in this settingRVU20A
2019-10-01$418.48Not available in this settingRVU19D
2019-07-01$418.48Not available in this settingRVU19C
2019-04-01$418.48Not available in this settingRVU19B
2019-01-01$418.48Not available in this settingRVU19A
2018-10-01$427.09Not available in this settingRVU18D
2018-07-01$427.09Not available in this settingRVU18C
2018-04-01$427.09Not available in this settingRVU18B
2018-01-01$427.09Not available in this settingRVU18AR1
2017-10-01$423.30Not available in this settingRVU17D
2017-07-01$423.30Not available in this settingRVU17C
2017-04-01$423.30Not available in this settingRVU17B
2017-01-01$423.30Not available in this settingRVU17A
2016-10-01$422.97Not available in this settingRVU16D
2016-07-01$422.97Not available in this settingRVU16C
2016-04-01$422.97Not available in this settingRVU16B
2016-01-01$422.97Not available in this settingRVU16A
2015-10-01$422.42Not available in this settingRVU15D
2015-07-01$422.42Not available in this settingRVU15C
2015-04-01$420.32Not available in this settingRVU15B
2015-01-01$420.32Not available in this settingRVU15A
2014-10-01$414.70Not available in this settingRVU14D
2014-07-01$414.70Not available in this settingRVU14C
2014-04-01$414.70Not available in this settingRVU14B
2014-01-01$414.70Not available in this settingRVU14A
2013-10-01$425.12Not available in this settingRVU13D
2013-07-01$425.12Not available in this settingRVU13C
2013-04-01$425.12Not available in this settingRVU13B
2013-01-01$425.12Not available in this settingRVU13AR

Price 78451 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

78451 billing questions

When is 78451 reported instead of 78452?

Use 78451 for one SPECT myocardial perfusion study at rest or stress. When the service includes both rest and stress studies, compare the documentation with 78452.

Does one study mean one image or one view?

No. The distinction is the number of myocardial perfusion studies, not the number of image slices or views. Document whether the single study was performed at rest or stress.

How should the professional and technical work be billed?

Use modifier 26 for the physician's interpretation and modifier TC for the equipment and staff. Report the global service without either component modifier when one claim includes both portions.

Can the technical component be reduced when other tests are performed?

The cardiovascular diagnostic multiple procedure reduction applies to the technical component of 78451. It does not change the professional component.

What documentation supports 78451?

Document that myocardial perfusion SPECT was performed, whether the single study was at rest or stress, and the physician's interpretation. For stress imaging, identify the stress method used.

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

Show the CMS file lines behind this rate
RVUs for 78451PPRRVU2026_Oct_nonQPP.csv, line 9,365 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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