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CPT code 78452: Nuclear stress test, SPECT, multiple perfusion studies2026 Medicare rate & RVUs in Delaware

Myocardial perfusion SPECT with multiple distinct studies, typically rest and stress imaging, is reported for the complete multiple-study examination.

CMS RVU26DEffective Oct 1, 2026One payment locality1.2M Medicare services in 2024

In Delaware, Medicare pays $423.24 for 78452 in the office.

$423.24Office (non-facility)
Not available in this settingHospital or facility
−1.1%vs the national office rate ($427.87)

Check a contract rate as a % of Medicare · 78452 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 78452 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 78452 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 78452 covers

Myocardial perfusion SPECT uses a radiotracer, such as technetium-99m sestamibi or tetrofosmin, and a gamma camera to assess blood flow to the heart muscle. Separate studies are commonly acquired at rest and after exercise or pharmacologic stress; redistribution or reinjection imaging may also be performed. Comparing the studies helps distinguish reversible perfusion defects from fixed defects. Attenuation correction, wall motion, ejection fraction, and additional quantification are included when performed. Nuclear cardiology teams perform the scan in offices, imaging centers, and hospital departments; a cardiologist or nuclear medicine physician interprets it.

Report one unit for the complete multiple-study SPECT examination, even when its phases occur on different days. Document the distinct study phases, tracer, stress method, and imaging findings. A separately performed and documented cardiovascular stress test may be reported with 93015 or the appropriate 93016–93018 components; tracer and stress-agent billing depends on the setting. Use modifier 26 for interpretation only, TC for the equipment and staff portion, or no component modifier for the global service. CMS applies the cardiovascular diagnostic multiple procedure reduction to the technical component when applicable.

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 Delaware compares for 78452

Across 109 of 109 payment localities, the office rate for 78452 runs from $373.48 in Arkansas to $595.53 in San Benito County, CA. Delaware pays $423.24. The RVUs are the same everywhere; the geographic indexes change the dollars.

78452 in Delaware vs other payment areas
  1. Delaware · this page$423.24
  2. Los Angeles, CA · California$496.42+$73.18
  3. Washington, DC area · District of Columbia$497.20+$73.96
  4. Miami, FL · Florida$449.71+$26.47
  5. Chicago, IL · Illinois$435.71+$12.47
  6. Manhattan, NY · New York$493.85+$70.61
  7. Alaska · Alaska$476.40+$53.16

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

Every other payment area

78452 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$379.64—
ArkansasArkansas$373.48—
ArizonaArizona$415.75—
Bakersfield, CACalifornia$462.76—
Chico, CACalifornia$462.34—
El Centro, CACalifornia$462.36—
Fresno, CACalifornia$462.34—
Hanford, CACalifornia$462.34—

78452 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.

$373.48

$528.94

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

View every state and territory as a table
78452 office rate range by state
State / territoryOffice rate rangeLocalities
AK$476.401
AL$379.641
AR$373.481
AZ$415.751
CA$462.34–$595.5329
CO$451.281
CT$458.381
DC$497.201
DE$423.241
FL$413.74–$449.713
GA$388.66–$434.832
GU$476.831
HI$476.831
IA$393.731
ID$395.921
IL$398.05–$441.604
IN$398.571
KS$390.121
KY$386.341
LA$385.05–$406.582
MA$447.48–$501.482
MD$432.49–$497.203
ME$396.56–$422.932
MI$396.17–$417.872
MN$435.561
MO$376.59–$410.083
MS$375.201
MT$427.861
NC$401.461
ND$425.291
NE$396.621
NH$442.521
NJ$464.51–$490.812
NM$397.971
NV$427.511
NY$408.04–$505.045
OH$395.651
OK$387.231
OR$425.09–$468.752
PA$397.23–$444.852
PR$431.881
RI$440.631
SC$399.041
SD$424.981
TN$392.121
TX$394.19–$448.988
UT$405.181
VA$420.29–$497.202
VI$431.881
VT$422.011
WA$447.16–$513.872
WI$409.291
WV$381.171
WY$426.741

See 78452 in every payment locality

How the 78452 rate is calculated

Each of 78452’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 · 78452

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.58

1.58 RVUs× 1.000 GPCI

Practice expense11.10

11.10 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

12.8100

Conversion factor

$33.4009

Medicare rate

$427.87

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,368

Code
78452
Physician work
1.58
Practice expense
11.10
Malpractice
0.13

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 78452 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.58× 1.0051.5879
Practice expense11.10× 0.98810.9668
Malpractice0.13× 0.8990.1169
Total RVUs12.6716
Conversion factor× 33.4009

Office rate, Delaware$423.24

Office: (1.58 × 1.005 + 11.1 × 0.988 + 0.13 × 0.899) × $33.4009 = $423.24

Open 78452 in the RVU calculator

Payment rules and modifiers for 78452

The CMS indicators that decide how 78452 is paid alongside other services.

CMS payment indicators · 78452

Nuclear stress test, SPECT, multiple perfusion studies

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

78452 without 26 · national office

$427.87

Nuclear stress test, SPECT, multiple perfusion studies

78452-26 · Professional component

$74.48

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78452

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

Codes related to 78452
CodeHow it relatesOffice range, Delaware
Same family
78451Cardiac SPECT, single rest or stress studySingle-study SPECT perfusion version, such as a stress-only protocol.$308.03
78454Heart imaging, multiple planar studiesPlanar, non-tomographic perfusion imaging with multiple studies.$377.85
78453Heart perfusion imaging, single planar studyPlanar perfusion imaging with a single study.$259.97
Often billed with
93015Cardiac stress test, global: supervision, tracing, interpretationGlobal cardiovascular stress test, when separately performed with the stress imaging.$72.90
93018Stress test interpretation, interpretation and report onlySeparate interpretation and report of the cardiovascular stress test, when performed.$13.66
Used instead
78492PET perfusion, multiple studiesPET perfusion with multiple studies instead of SPECT.No office rate
78431Cardiac PET, rest and stress with CTPET rest and stress perfusion with concurrently acquired CT instead of SPECT.No office rate

How 78452 has changed in Delaware

78452 · Office / nonfacility

$423.24

Effective 2026-10-01

The base rate is $16.93 higher than on 2025-10-01, moving from $406.31 to $423.24 (4.2%).

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

    $406.31changed to$423.24

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.62 changed to 1.58
    • Practice expense RVU 10.90 changed to 11.10
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $429.66changed to$406.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.23 changed to 10.90
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $422.65changed to$429.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $447.07changed to$422.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.36 changed to 11.23
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $473.19changed to$447.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.65 changed to 11.36
    • Malpractice RVU 0.15 changed to 0.13
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $495.79changed to$473.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.21 changed to 11.65
    • Malpractice RVU 0.11 changed to 0.15

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $493.99changed to$495.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.67 changed to 12.21
    • Malpractice RVU 0.14 changed to 0.11
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $499.18changed to$493.99

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.86 changed to 11.67
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $509.67changed to$499.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.15 changed to 11.86
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $506.37changed to$509.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.04 changed to 12.15
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $507.45changed to$506.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.02 changed to 12.04
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $507.02changed to$507.45

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.98 changed to 12.02
    • Malpractice RVU 0.11 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $504.50changed to$507.02

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $502.93changed to$504.50

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.87 changed to 11.98
    • Malpractice RVU 0.09 changed to 0.11
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $521.37changed to$502.93

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.05 changed to 11.87
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $521.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$423.24Not available in this settingRVU26D
2026-07-01$423.24Not available in this settingRVU26C
2026-04-01$423.24Not available in this settingRVU26B
2026-01-01$423.24Not available in this settingRVU26A
2025-10-01$406.31Not available in this settingRVU25D
2025-07-01$406.31Not available in this settingRVU25C
2025-04-01$406.31Not available in this settingRVU25B
2025-01-01$406.31Not available in this settingRVU25A
2024-10-01$429.66Not available in this settingRVU24D
2024-07-01$429.66Not available in this settingRVU24C
2024-04-01$429.66Not available in this settingRVU24B
2024-03-09$429.66Not available in this settingRVU24AR
2024-01-01$422.65Not available in this settingRVU24A
2023-10-01$447.07Not available in this settingRVU23D
2023-07-01$447.07Not available in this settingRVU23C
2023-04-01$447.07Not available in this settingRVU23B
2023-01-01$447.07Not available in this settingRVU23A
2022-10-01$473.19Not available in this settingRVU22D
2022-07-01$473.19Not available in this settingRVU22C
2022-04-01$473.19Not available in this settingRVU22B
2022-01-01$473.19Not available in this settingRVU22A
2021-10-01$495.79Not available in this settingRVU21D
2021-07-01$495.79Not available in this settingRVU21C
2021-04-01$495.79Not available in this settingRVU21B
2021-01-01$495.79Not available in this settingRVU21A
2020-10-01$493.99Not available in this settingRVU20D
2020-07-01$493.99Not available in this settingRVU20C
2020-04-01$493.99Not available in this settingRVU20B
2020-01-01$493.99Not available in this settingRVU20A
2019-10-01$499.18Not available in this settingRVU19D
2019-07-01$499.18Not available in this settingRVU19C
2019-04-01$499.18Not available in this settingRVU19B
2019-01-01$499.18Not available in this settingRVU19A
2018-10-01$509.67Not available in this settingRVU18D
2018-07-01$509.67Not available in this settingRVU18C
2018-04-01$509.67Not available in this settingRVU18B
2018-01-01$509.67Not available in this settingRVU18AR1
2017-10-01$506.37Not available in this settingRVU17D
2017-07-01$506.37Not available in this settingRVU17C
2017-04-01$506.37Not available in this settingRVU17B
2017-01-01$506.37Not available in this settingRVU17A
2016-10-01$507.45Not available in this settingRVU16D
2016-07-01$507.45Not available in this settingRVU16C
2016-04-01$507.45Not available in this settingRVU16B
2016-01-01$507.45Not available in this settingRVU16A
2015-10-01$507.02Not available in this settingRVU15D
2015-07-01$507.02Not available in this settingRVU15C
2015-04-01$504.50Not available in this settingRVU15B
2015-01-01$504.50Not available in this settingRVU15A
2014-10-01$502.93Not available in this settingRVU14D
2014-07-01$502.93Not available in this settingRVU14C
2014-04-01$502.93Not available in this settingRVU14B
2014-01-01$502.93Not available in this settingRVU14A
2013-10-01$521.37Not available in this settingRVU13D
2013-07-01$521.37Not available in this settingRVU13C
2013-04-01$521.37Not available in this settingRVU13B
2013-01-01$521.37Not available in this settingRVU13AR

Price 78452 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

78452 billing questions

When should 78451 be used instead of 78452?

Use 78451 for one SPECT perfusion study, such as a stress-only protocol in which rest imaging is omitted. Use 78452 when multiple distinct perfusion studies are performed, such as rest and stress.

Is the treadmill or pharmacologic stress test included?

The separately performed and documented cardiovascular stress test may be reported with 93015, or with the appropriate components 93016, 93017, and 93018 when the work is split. Separate billing for the radiotracer or pharmacologic stress agent depends on the setting.

Can gated wall motion or ejection fraction be billed separately?

Wall motion, ejection fraction, attenuation correction, and additional quantification are included in 78452 when performed. Do not add a gated blood pool code solely to report function data obtained from the perfusion study.

How is a two-day protocol reported?

Report one unit of 78452 for the complete multiple-study examination when its phases occur on two days. Document the phases performed on each day.

Which modifiers apply in a hospital setting?

A physician billing only the interpretation uses 78452-26; the hospital bills its facility services separately. A practice furnishing both the technical service and interpretation bills the global code without a component modifier.

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 78452PPRRVU2026_Oct_nonQPP.csv, line 9,368 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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