CPT code 78451: Cardiac SPECT, single rest or stress study2026 Medicare rate & RVUs in Utah
Reports one SPECT myocardial perfusion study at rest or stress to assess blood flow to the heart muscle in suspected or known coronary disease.
In Utah, Medicare pays $295.18 for 78451 in the office.
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.
On this page 11 sections
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 Utah 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. Utah pays $295.18. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Utah · this page$295.18
- Los Angeles, CA · California$360.13+$64.95
- Washington, DC area · District of Columbia$360.90+$65.72
- Miami, FL · Florida$327.18+$32.00
- Chicago, IL · Illinois$317.25+$22.07
- Manhattan, NY · New York$358.72+$63.54
- Alaska · Alaska$349.43+$54.25
Other areas in Utah first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $276.99 | — |
| ArkansasArkansas | $272.61 | — |
| ArizonaArizona | $302.67 | — |
| Bakersfield, CACalifornia | $336.08 | — |
| Chico, CACalifornia | $335.75 | — |
| El Centro, CACalifornia | $335.76 | — |
| Fresno, CACalifornia | $335.75 | — |
| Hanford, CACalifornia | $335.75 | — |
| Madera, CACalifornia | $335.75 | — |
| Merced, CACalifornia | $335.75 | — |
| Modesto, CACalifornia | $335.75 | — |
| Napa, CACalifornia | $396.08 | — |
| Oxnard, CACalifornia | $359.14 | — |
| Redding, CACalifornia | $335.75 | — |
| Rest of CaliforniaCalifornia | $335.75 | — |
| Riverside, CACalifornia | $336.85 | — |
| Sacramento, CACalifornia | $354.22 | — |
| Salinas, CACalifornia | $352.94 | — |
| San Diego, CACalifornia | $362.64 | — |
| Marin County, CACalifornia | $421.55 | — |
| San Francisco, CACalifornia | $421.43 | — |
| San Benito County, CACalifornia | $430.89 | — |
| Santa Clara County, CACalifornia | $430.43 | — |
| San Luis Obispo, CACalifornia | $347.05 | — |
| Santa Cruz, CACalifornia | $367.21 | — |
| Santa Maria, CACalifornia | $354.64 | — |
| Santa Rosa, CACalifornia | $371.03 | — |
| Stockton, CACalifornia | $335.75 | — |
| Vallejo, CACalifornia | $395.92 | — |
| Visalia, CACalifornia | $335.75 | — |
| Yuba City, CACalifornia | $335.75 | — |
| ColoradoColorado | $327.93 | — |
| ConnecticutConnecticut | $333.14 | — |
| DelawareDelaware | $308.03 | — |
| Fort Lauderdale, FLFlorida | $317.41 | — |
| Rest of FloridaFlorida | $301.41 | — |
| Atlanta, GAGeorgia | $316.31 | — |
| Rest of GeorgiaGeorgia | $283.55 | — |
| Hawaii, Guam, HIHawaii | $345.90 | — |
| IowaIowa | $286.94 | — |
| IdahoIdaho | $288.51 | — |
| East St. Louis, ILIllinois | $293.65 | — |
| Rest of IllinoisIllinois | $290.31 | — |
| Suburban Chicago, ILIllinois | $321.29 | — |
| IndianaIndiana | $290.39 | — |
| KansasKansas | $284.40 | — |
| KentuckyKentucky | $281.83 | — |
| New Orleans, LALouisiana | $296.24 | — |
| Rest of LouisianaLouisiana | $280.93 | — |
| Metropolitan Boston, MAMassachusetts | $363.77 | — |
| Rest of MassachusettsMassachusetts | $325.27 | — |
| Baltimore area, MDMaryland | $332.00 | — |
| Rest of MarylandMaryland | $314.63 | — |
| Rest of MaineMaine | $289.00 | — |
| Southern Maine, MEMaine | $307.70 | — |
| Detroit, MIMichigan | $304.39 | — |
| Rest of MichiganMichigan | $288.86 | — |
| MinnesotaMinnesota | $316.57 | — |
| Metropolitan Kansas City, MOMissouri | $295.18 | — |
| Metropolitan St. Louis, MOMissouri | $298.69 | — |
| Rest of MissouriMissouri | $274.93 | — |
| MississippiMississippi | $273.89 | — |
| MontanaMontana | $311.29 | — |
| North CarolinaNorth Carolina | $292.48 | — |
| North DakotaNorth Dakota | $309.31 | — |
| NebraskaNebraska | $288.98 | — |
| New HampshireNew Hampshire | $321.66 | — |
| Northern New JerseyNew Jersey | $356.42 | — |
| Rest of New JerseyNew Jersey | $337.61 | — |
| New MexicoNew Mexico | $290.15 | — |
| NevadaNevada | $311.00 | — |
| NYC suburbs and Long Island, NYNew York | $366.73 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $339.00 | — |
| Queens, NYNew York | $363.50 | — |
| Rest of New YorkNew York | $297.16 | — |
| OhioOhio | $288.45 | — |
| OklahomaOklahoma | $282.42 | — |
| Portland, OROregon | $340.34 | — |
| Rest of OregonOregon | $309.25 | — |
| Metropolitan Philadelphia, PAPennsylvania | $323.53 | — |
| Rest of PennsylvaniaPennsylvania | $289.56 | — |
| Puerto RicoPuerto Rico | $314.14 | — |
| Rhode IslandRhode Island | $320.47 | — |
| South CarolinaSouth Carolina | $290.82 | — |
| South DakotaSouth Dakota | $309.08 | — |
| TennesseeTennessee | $285.83 | — |
| Austin, TXTexas | $326.25 | — |
| Beaumont, TXTexas | $287.40 | — |
| Brazoria, TXTexas | $308.56 | — |
| Dallas, TXTexas | $310.18 | — |
| Fort Worth, TXTexas | $307.59 | — |
| Galveston, TXTexas | $309.24 | — |
| Houston, TXTexas | $311.07 | — |
| Rest of TexasTexas | $297.57 | — |
| VirginiaVirginia | $305.85 | — |
| Virgin Islands, VIUnited States Virgin Islands | $314.14 | — |
| VermontVermont | $307.02 | — |
| Rest of WashingtonWashington | $325.02 | — |
| King County, WAWashington | $372.61 | — |
| WisconsinWisconsin | $297.94 | — |
| West VirginiaWest Virginia | $278.30 | — |
| WyomingWyoming | $310.43 | — |
78451 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $349.43 | 1 |
| AL | $276.99 | 1 |
| AR | $272.61 | 1 |
| AZ | $302.67 | 1 |
| CA | $335.75–$430.89 | 29 |
| CO | $327.93 | 1 |
| CT | $333.14 | 1 |
| DC | $360.90 | 1 |
| DE | $308.03 | 1 |
| FL | $301.41–$327.18 | 3 |
| GA | $283.55–$316.31 | 2 |
| GU | $345.90 | 1 |
| HI | $345.90 | 1 |
| IA | $286.94 | 1 |
| ID | $288.51 | 1 |
| IL | $290.31–$321.29 | 4 |
| IN | $290.39 | 1 |
| KS | $284.40 | 1 |
| KY | $281.83 | 1 |
| LA | $280.93–$296.24 | 2 |
| MA | $325.27–$363.77 | 2 |
| MD | $314.63–$360.90 | 3 |
| ME | $289.00–$307.70 | 2 |
| MI | $288.86–$304.39 | 2 |
| MN | $316.57 | 1 |
| MO | $274.93–$298.69 | 3 |
| MS | $273.89 | 1 |
| MT | $311.29 | 1 |
| NC | $292.48 | 1 |
| ND | $309.31 | 1 |
| NE | $288.98 | 1 |
| NH | $321.66 | 1 |
| NJ | $337.61–$356.42 | 2 |
| NM | $290.15 | 1 |
| NV | $311.00 | 1 |
| NY | $297.16–$366.73 | 5 |
| OH | $288.45 | 1 |
| OK | $282.42 | 1 |
| OR | $309.25–$340.34 | 2 |
| PA | $289.56–$323.53 | 2 |
| PR | $314.14 | 1 |
| RI | $320.47 | 1 |
| SC | $290.82 | 1 |
| SD | $309.08 | 1 |
| TN | $285.83 | 1 |
| TX | $287.40–$326.25 | 8 |
| UT | $295.18 | 1 |
| VA | $305.85–$360.90 | 2 |
| VI | $314.14 | 1 |
| VT | $307.02 | 1 |
| WA | $325.02–$372.61 | 2 |
| WI | $297.94 | 1 |
| WV | $278.30 | 1 |
| WY | $310.43 | 1 |
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
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 Utah 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
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.35 | × 1.000 | 1.3500 |
| Practice expense | 7.87 | × 0.940 | 7.3978 |
| Malpractice | 0.10 | × 0.898 | 0.0898 |
| Total RVUs | 8.8376 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Utah$295.18
Office: (1.35 × 1 + 7.87 × 0.94 + 0.1 × 0.898) × $33.4009 = $295.18
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| 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
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.
How 78451 has changed in Utah
78451 · Office / nonfacility
$295.18
Effective 2026-10-01
The base rate is $15.15 higher than on 2025-10-01, moving from $280.03 to $295.18 (5.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$280.03changed to$295.18
- 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
- Practice expense GPCI 0.933 changed to 0.940
- Malpractice GPCI 0.930 changed to 0.898
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$294.70changed to$280.03
- 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.
March 9, 2024
RVU24AR
$289.89changed to$294.70
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$299.83changed to$289.89
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.865 changed to 0.930
January 1, 2023
RVU23A
$309.72changed to$299.83
- 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
- Practice expense GPCI 0.919 changed to 0.926
- Malpractice GPCI 0.799 changed to 0.865
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$324.47changed to$309.72
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.53 changed to 8.15
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$324.83changed to$324.47
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.15 changed to 8.53
- Practice expense GPCI 0.923 changed to 0.919
- Malpractice GPCI 0.982 changed to 0.799
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$330.89changed to$324.83
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.29 changed to 8.15
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.165 changed to 0.982
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$337.53changed to$330.89
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.50 changed to 8.29
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$333.90changed to$337.53
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.44 changed to 8.50
- Practice expense GPCI 0.925 changed to 0.927
- Malpractice GPCI 1.167 changed to 1.165
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$332.87changed to$333.90
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.46 changed to 8.44
- Practice expense GPCI 0.922 changed to 0.925
- Malpractice GPCI 1.169 changed to 1.167
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$332.66changed to$332.87
- 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.
July 1, 2015
RVU15C
$331.01changed to$332.66
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$326.92changed to$331.01
- 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
- Practice expense GPCI 0.919 changed to 0.922
- Malpractice GPCI 1.136 changed to 1.169
Held through RVU15B.
January 1, 2014
RVU14A
$334.49changed to$326.92
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.13 changed to 8.33
- Practice expense GPCI 0.916 changed to 0.919
- Malpractice GPCI 1.102 changed to 1.136
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $334.49
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $295.18 | Not available in this setting | RVU26D |
| 2026-07-01 | $295.18 | Not available in this setting | RVU26C |
| 2026-04-01 | $295.18 | Not available in this setting | RVU26B |
| 2026-01-01 | $295.18 | Not available in this setting | RVU26A |
| 2025-10-01 | $280.03 | Not available in this setting | RVU25D |
| 2025-07-01 | $280.03 | Not available in this setting | RVU25C |
| 2025-04-01 | $280.03 | Not available in this setting | RVU25B |
| 2025-01-01 | $280.03 | Not available in this setting | RVU25A |
| 2024-10-01 | $294.70 | Not available in this setting | RVU24D |
| 2024-07-01 | $294.70 | Not available in this setting | RVU24C |
| 2024-04-01 | $294.70 | Not available in this setting | RVU24B |
| 2024-03-09 | $294.70 | Not available in this setting | RVU24AR |
| 2024-01-01 | $289.89 | Not available in this setting | RVU24A |
| 2023-10-01 | $299.83 | Not available in this setting | RVU23D |
| 2023-07-01 | $299.83 | Not available in this setting | RVU23C |
| 2023-04-01 | $299.83 | Not available in this setting | RVU23B |
| 2023-01-01 | $299.83 | Not available in this setting | RVU23A |
| 2022-10-01 | $309.72 | Not available in this setting | RVU22D |
| 2022-07-01 | $309.72 | Not available in this setting | RVU22C |
| 2022-04-01 | $309.72 | Not available in this setting | RVU22B |
| 2022-01-01 | $309.72 | Not available in this setting | RVU22A |
| 2021-10-01 | $324.47 | Not available in this setting | RVU21D |
| 2021-07-01 | $324.47 | Not available in this setting | RVU21C |
| 2021-04-01 | $324.47 | Not available in this setting | RVU21B |
| 2021-01-01 | $324.47 | Not available in this setting | RVU21A |
| 2020-10-01 | $324.83 | Not available in this setting | RVU20D |
| 2020-07-01 | $324.83 | Not available in this setting | RVU20C |
| 2020-04-01 | $324.83 | Not available in this setting | RVU20B |
| 2020-01-01 | $324.83 | Not available in this setting | RVU20A |
| 2019-10-01 | $330.89 | Not available in this setting | RVU19D |
| 2019-07-01 | $330.89 | Not available in this setting | RVU19C |
| 2019-04-01 | $330.89 | Not available in this setting | RVU19B |
| 2019-01-01 | $330.89 | Not available in this setting | RVU19A |
| 2018-10-01 | $337.53 | Not available in this setting | RVU18D |
| 2018-07-01 | $337.53 | Not available in this setting | RVU18C |
| 2018-04-01 | $337.53 | Not available in this setting | RVU18B |
| 2018-01-01 | $337.53 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $333.90 | Not available in this setting | RVU17D |
| 2017-07-01 | $333.90 | Not available in this setting | RVU17C |
| 2017-04-01 | $333.90 | Not available in this setting | RVU17B |
| 2017-01-01 | $333.90 | Not available in this setting | RVU17A |
| 2016-10-01 | $332.87 | Not available in this setting | RVU16D |
| 2016-07-01 | $332.87 | Not available in this setting | RVU16C |
| 2016-04-01 | $332.87 | Not available in this setting | RVU16B |
| 2016-01-01 | $332.87 | Not available in this setting | RVU16A |
| 2015-10-01 | $332.66 | Not available in this setting | RVU15D |
| 2015-07-01 | $332.66 | Not available in this setting | RVU15C |
| 2015-04-01 | $331.01 | Not available in this setting | RVU15B |
| 2015-01-01 | $331.01 | Not available in this setting | RVU15A |
| 2014-10-01 | $326.92 | Not available in this setting | RVU14D |
| 2014-07-01 | $326.92 | Not available in this setting | RVU14C |
| 2014-04-01 | $326.92 | Not available in this setting | RVU14B |
| 2014-01-01 | $326.92 | Not available in this setting | RVU14A |
| 2013-10-01 | $334.49 | Not available in this setting | RVU13D |
| 2013-07-01 | $334.49 | Not available in this setting | RVU13C |
| 2013-04-01 | $334.49 | Not available in this setting | RVU13B |
| 2013-01-01 | $334.49 | Not available in this setting | RVU13AR |
Where the Utah rate applies
Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.
- Alpine
- Alta
- Altamont
- Alton
- Amalga
- American Fork
- Aneth
- Annabella
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
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