CPT code 78452: Nuclear stress test, SPECT, multiple perfusion studies2026 Medicare rate & RVUs in Vermont
Myocardial perfusion SPECT with multiple distinct studies, typically rest and stress imaging, is reported for the complete multiple-study examination.
In Vermont, Medicare pays $422.01 for 78452 in the office.
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.
On this page 11 sections
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 Vermont 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. Vermont pays $422.01. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$422.01
- Los Angeles, CA · California$496.42+$74.41
- Washington, DC area · District of Columbia$497.20+$75.19
- Miami, FL · Florida$449.71+$27.70
- Chicago, IL · Illinois$435.71+$13.70
- Manhattan, NY · New York$493.85+$71.84
- Alaska · Alaska$476.40+$54.39
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $462.34 | — |
| Merced, CACalifornia | $462.34 | — |
| Modesto, CACalifornia | $462.34 | — |
| Napa, CACalifornia | $546.95 | — |
| Oxnard, CACalifornia | $495.18 | — |
| Redding, CACalifornia | $462.34 | — |
| Rest of CaliforniaCalifornia | $462.34 | — |
| Riverside, CACalifornia | $463.77 | — |
| Sacramento, CACalifornia | $488.18 | — |
| Salinas, CACalifornia | $486.44 | — |
| San Diego, CACalifornia | $500.13 | — |
| Marin County, CACalifornia | $582.54 | — |
| San Francisco, CACalifornia | $582.39 | — |
| San Benito County, CACalifornia | $595.53 | — |
| Santa Clara County, CACalifornia | $594.92 | — |
| San Luis Obispo, CACalifornia | $478.28 | — |
| Santa Cruz, CACalifornia | $506.67 | — |
| Santa Maria, CACalifornia | $488.87 | — |
| Santa Rosa, CACalifornia | $511.96 | — |
| Stockton, CACalifornia | $462.34 | — |
| Vallejo, CACalifornia | $546.74 | — |
| Visalia, CACalifornia | $462.34 | — |
| Yuba City, CACalifornia | $462.34 | — |
| ColoradoColorado | $451.28 | — |
| ConnecticutConnecticut | $458.38 | — |
| DelawareDelaware | $423.24 | — |
| Fort Lauderdale, FLFlorida | $436.19 | — |
| Rest of FloridaFlorida | $413.74 | — |
| Atlanta, GAGeorgia | $434.83 | — |
| Rest of GeorgiaGeorgia | $388.66 | — |
| Hawaii, Guam, HIHawaii | $476.83 | — |
| IowaIowa | $393.73 | — |
| IdahoIdaho | $395.92 | — |
| East St. Louis, ILIllinois | $402.61 | — |
| Rest of IllinoisIllinois | $398.05 | — |
| Suburban Chicago, ILIllinois | $441.60 | — |
| IndianaIndiana | $398.57 | — |
| KansasKansas | $390.12 | — |
| KentuckyKentucky | $386.34 | — |
| New Orleans, LALouisiana | $406.58 | — |
| Rest of LouisianaLouisiana | $385.05 | — |
| Metropolitan Boston, MAMassachusetts | $501.48 | — |
| Rest of MassachusettsMassachusetts | $447.48 | — |
| Baltimore area, MDMaryland | $456.80 | — |
| Rest of MarylandMaryland | $432.49 | — |
| Rest of MaineMaine | $396.56 | — |
| Southern Maine, MEMaine | $422.93 | — |
| Detroit, MIMichigan | $417.87 | — |
| Rest of MichiganMichigan | $396.17 | — |
| MinnesotaMinnesota | $435.56 | — |
| Metropolitan Kansas City, MOMissouri | $405.15 | — |
| Metropolitan St. Louis, MOMissouri | $410.08 | — |
| Rest of MissouriMissouri | $376.59 | — |
| MississippiMississippi | $375.20 | — |
| MontanaMontana | $427.86 | — |
| North CarolinaNorth Carolina | $401.46 | — |
| North DakotaNorth Dakota | $425.29 | — |
| NebraskaNebraska | $396.62 | — |
| New HampshireNew Hampshire | $442.52 | — |
| Northern New JerseyNew Jersey | $490.81 | — |
| Rest of New JerseyNew Jersey | $464.51 | — |
| New MexicoNew Mexico | $397.97 | — |
| NevadaNevada | $427.51 | — |
| NYC suburbs and Long Island, NYNew York | $505.04 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $466.37 | — |
| Queens, NYNew York | $500.64 | — |
| Rest of New YorkNew York | $408.04 | — |
| OhioOhio | $395.65 | — |
| OklahomaOklahoma | $387.23 | — |
| Portland, OROregon | $468.75 | — |
| Rest of OregonOregon | $425.09 | — |
| Metropolitan Philadelphia, PAPennsylvania | $444.85 | — |
| Rest of PennsylvaniaPennsylvania | $397.23 | — |
| Puerto RicoPuerto Rico | $431.88 | — |
| Rhode IslandRhode Island | $440.63 | — |
| South CarolinaSouth Carolina | $399.04 | — |
| South DakotaSouth Dakota | $424.98 | — |
| TennesseeTennessee | $392.12 | — |
| Austin, TXTexas | $448.98 | — |
| Beaumont, TXTexas | $394.19 | — |
| Brazoria, TXTexas | $424.00 | — |
| Dallas, TXTexas | $426.24 | — |
| Fort Worth, TXTexas | $422.59 | — |
| Galveston, TXTexas | $424.95 | — |
| Houston, TXTexas | $427.33 | — |
| Rest of TexasTexas | $408.54 | — |
| UtahUtah | $405.18 | — |
| VirginiaVirginia | $420.29 | — |
| Virgin Islands, VIUnited States Virgin Islands | $431.88 | — |
| Rest of WashingtonWashington | $447.16 | — |
| King County, WAWashington | $513.87 | — |
| WisconsinWisconsin | $409.29 | — |
| West VirginiaWest Virginia | $381.17 | — |
| WyomingWyoming | $426.74 | — |
78452 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.
$373.48
$528.94
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 | $476.40 | 1 |
| AL | $379.64 | 1 |
| AR | $373.48 | 1 |
| AZ | $415.75 | 1 |
| CA | $462.34–$595.53 | 29 |
| CO | $451.28 | 1 |
| CT | $458.38 | 1 |
| DC | $497.20 | 1 |
| DE | $423.24 | 1 |
| FL | $413.74–$449.71 | 3 |
| GA | $388.66–$434.83 | 2 |
| GU | $476.83 | 1 |
| HI | $476.83 | 1 |
| IA | $393.73 | 1 |
| ID | $395.92 | 1 |
| IL | $398.05–$441.60 | 4 |
| IN | $398.57 | 1 |
| KS | $390.12 | 1 |
| KY | $386.34 | 1 |
| LA | $385.05–$406.58 | 2 |
| MA | $447.48–$501.48 | 2 |
| MD | $432.49–$497.20 | 3 |
| ME | $396.56–$422.93 | 2 |
| MI | $396.17–$417.87 | 2 |
| MN | $435.56 | 1 |
| MO | $376.59–$410.08 | 3 |
| MS | $375.20 | 1 |
| MT | $427.86 | 1 |
| NC | $401.46 | 1 |
| ND | $425.29 | 1 |
| NE | $396.62 | 1 |
| NH | $442.52 | 1 |
| NJ | $464.51–$490.81 | 2 |
| NM | $397.97 | 1 |
| NV | $427.51 | 1 |
| NY | $408.04–$505.04 | 5 |
| OH | $395.65 | 1 |
| OK | $387.23 | 1 |
| OR | $425.09–$468.75 | 2 |
| PA | $397.23–$444.85 | 2 |
| PR | $431.88 | 1 |
| RI | $440.63 | 1 |
| SC | $399.04 | 1 |
| SD | $424.98 | 1 |
| TN | $392.12 | 1 |
| TX | $394.19–$448.98 | 8 |
| UT | $405.18 | 1 |
| VA | $420.29–$497.20 | 2 |
| VI | $431.88 | 1 |
| VT | $422.01 | 1 |
| WA | $447.16–$513.87 | 2 |
| WI | $409.29 | 1 |
| WV | $381.17 | 1 |
| WY | $426.74 | 1 |
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
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 Vermont 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
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.58 | × 1.000 | 1.5800 |
| Practice expense | 11.10 | × 0.990 | 10.9890 |
| Malpractice | 0.13 | × 0.506 | 0.0658 |
| Total RVUs | 12.6348 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vermont$422.01
Office: (1.58 × 1 + 11.1 × 0.99 + 0.13 × 0.506) × $33.4009 = $422.01
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
| 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
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.
How 78452 has changed in Vermont
78452 · Office / nonfacility
$422.01
Effective 2026-10-01
The base rate is $17.49 higher than on 2025-10-01, moving from $404.52 to $422.01 (4.3%).
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
$404.52changed to$422.01
- 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
- Practice expense GPCI 0.993 changed to 0.990
- Malpractice GPCI 0.518 changed to 0.506
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$427.54changed to$404.52
- 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.
March 9, 2024
RVU24AR
$420.56changed to$427.54
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$441.09changed to$420.56
- 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
- Practice expense GPCI 0.997 changed to 0.993
- Malpractice GPCI 0.543 changed to 0.518
January 1, 2023
RVU23A
$462.58changed to$441.09
- 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
- Practice expense GPCI 1.001 changed to 0.997
- Malpractice GPCI 0.569 changed to 0.543
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$485.18changed to$462.58
- 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.
January 1, 2021
RVU21A
$485.94changed to$485.18
- 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
- Practice expense GPCI 1.008 changed to 1.001
- Malpractice GPCI 0.582 changed to 0.569
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$494.79changed to$485.94
- 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
- Practice expense GPCI 1.015 changed to 1.008
- Malpractice GPCI 0.595 changed to 0.582
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$505.06changed to$494.79
- 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.
January 1, 2018
RVU18AR1
$497.31changed to$505.06
- 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
- Practice expense GPCI 1.010 changed to 1.015
- Malpractice GPCI 0.639 changed to 0.595
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$493.27changed to$497.31
- 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
- Practice expense GPCI 1.004 changed to 1.010
- Malpractice GPCI 0.682 changed to 0.639
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$493.11changed to$493.27
- 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.
July 1, 2015
RVU15C
$490.66changed to$493.11
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$487.79changed to$490.66
- 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 1.006 changed to 1.004
- Malpractice GPCI 0.618 changed to 0.682
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$487.79
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $422.01 | Not available in this setting | RVU26D |
| 2026-07-01 | $422.01 | Not available in this setting | RVU26C |
| 2026-04-01 | $422.01 | Not available in this setting | RVU26B |
| 2026-01-01 | $422.01 | Not available in this setting | RVU26A |
| 2025-10-01 | $404.52 | Not available in this setting | RVU25D |
| 2025-07-01 | $404.52 | Not available in this setting | RVU25C |
| 2025-04-01 | $404.52 | Not available in this setting | RVU25B |
| 2025-01-01 | $404.52 | Not available in this setting | RVU25A |
| 2024-10-01 | $427.54 | Not available in this setting | RVU24D |
| 2024-07-01 | $427.54 | Not available in this setting | RVU24C |
| 2024-04-01 | $427.54 | Not available in this setting | RVU24B |
| 2024-03-09 | $427.54 | Not available in this setting | RVU24AR |
| 2024-01-01 | $420.56 | Not available in this setting | RVU24A |
| 2023-10-01 | $441.09 | Not available in this setting | RVU23D |
| 2023-07-01 | $441.09 | Not available in this setting | RVU23C |
| 2023-04-01 | $441.09 | Not available in this setting | RVU23B |
| 2023-01-01 | $441.09 | Not available in this setting | RVU23A |
| 2022-10-01 | $462.58 | Not available in this setting | RVU22D |
| 2022-07-01 | $462.58 | Not available in this setting | RVU22C |
| 2022-04-01 | $462.58 | Not available in this setting | RVU22B |
| 2022-01-01 | $462.58 | Not available in this setting | RVU22A |
| 2021-10-01 | $485.18 | Not available in this setting | RVU21D |
| 2021-07-01 | $485.18 | Not available in this setting | RVU21C |
| 2021-04-01 | $485.18 | Not available in this setting | RVU21B |
| 2021-01-01 | $485.18 | Not available in this setting | RVU21A |
| 2020-10-01 | $485.94 | Not available in this setting | RVU20D |
| 2020-07-01 | $485.94 | Not available in this setting | RVU20C |
| 2020-04-01 | $485.94 | Not available in this setting | RVU20B |
| 2020-01-01 | $485.94 | Not available in this setting | RVU20A |
| 2019-10-01 | $494.79 | Not available in this setting | RVU19D |
| 2019-07-01 | $494.79 | Not available in this setting | RVU19C |
| 2019-04-01 | $494.79 | Not available in this setting | RVU19B |
| 2019-01-01 | $494.79 | Not available in this setting | RVU19A |
| 2018-10-01 | $505.06 | Not available in this setting | RVU18D |
| 2018-07-01 | $505.06 | Not available in this setting | RVU18C |
| 2018-04-01 | $505.06 | Not available in this setting | RVU18B |
| 2018-01-01 | $505.06 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $497.31 | Not available in this setting | RVU17D |
| 2017-07-01 | $497.31 | Not available in this setting | RVU17C |
| 2017-04-01 | $497.31 | Not available in this setting | RVU17B |
| 2017-01-01 | $497.31 | Not available in this setting | RVU17A |
| 2016-10-01 | $493.27 | Not available in this setting | RVU16D |
| 2016-07-01 | $493.27 | Not available in this setting | RVU16C |
| 2016-04-01 | $493.27 | Not available in this setting | RVU16B |
| 2016-01-01 | $493.27 | Not available in this setting | RVU16A |
| 2015-10-01 | $493.11 | Not available in this setting | RVU15D |
| 2015-07-01 | $493.11 | Not available in this setting | RVU15C |
| 2015-04-01 | $490.66 | Not available in this setting | RVU15B |
| 2015-01-01 | $490.66 | Not available in this setting | RVU15A |
| 2014-10-01 | $487.79 | Not available in this setting | RVU14D |
| 2014-07-01 | $487.79 | Not available in this setting | RVU14C |
| 2014-04-01 | $487.79 | Not available in this setting | RVU14B |
| 2014-01-01 | $487.79 | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
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
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