CPT code 78454: Heart imaging, multiple planar studies2026 Medicare rate & RVUs

Medicare pays $382.11 for 78454 nationally in the office. Local office rates run $332.79–$532.23.

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

What 78454 covers

This service uses a nuclear medicine camera to produce planar images of myocardial perfusion in more than one study. A common clinical use is comparison of rest and stress images when evaluating suspected or known coronary artery disease. Nuclear medicine physicians, radiologists, and cardiology imaging teams may perform or interpret the examination in hospital or outpatient imaging settings. The defining feature is planar acquisition; SPECT myocardial imaging is coded in a different code family.

Select this code when the record supports multiple planar myocardial imaging studies, rather than a single study or tomographic imaging. Documentation should identify the imaging approach and the studies performed, with an interpretation addressing the myocardial images. The code has professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither for the global service. CMS’s cardiovascular diagnostic multiple-procedure reduction applies to the technical component; the professional component is not subject to that reduction.

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 78454 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

78454 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 78454 rate is calculated

Each of 78454’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.

Payment rules and modifiers for 78454

The CMS indicators that decide how 78454 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78454 compared with similar codes

How to choose

78453Heart perfusion imagingSingle planar study

Both use planar myocardial imaging; 78453 is for a single study, while 78454 is for multiple studies.

78452Nuclear stress testSPECT, multiple perfusion studies

Both describe multiple-study myocardial imaging, but 78452 is for SPECT acquisition and 78454 is for planar acquisition.

78451Cardiac SPECTSingle rest or stress study

78451 is single-study SPECT myocardial imaging. Choose 78454 for multiple planar studies.

Codes related to 78454

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

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

Open CMS sourceHow we calculate rates