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CPT code 78454: Heart imaging, multiple planar studies2026 Medicare rate & RVUs in Washington, DC area

Reports planar nuclear imaging of myocardial perfusion across multiple studies, commonly rest and stress acquisitions, when planar rather than tomographic imaging is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality4.7K Medicare services in 2024

In Washington, DC area, Medicare pays $444.39 for 78454 in the office.

$444.39Office (non-facility)
Not available in this settingHospital or facility
+16.3%vs the national office rate ($382.11)

Check a contract rate as a % of Medicare · 78454 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 78454 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 78454 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 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.

How Washington, DC area compares for 78454

Across 109 of 109 payment localities, the office rate for 78454 runs from $332.79 in Arkansas to $532.23 in San Benito County, CA. Washington, DC area pays $444.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

78454 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$444.39
  2. Los Angeles, CA · California$443.39−$1.00
  3. Miami, FL · Florida$402.94−$41.45
  4. Chicago, IL · Illinois$390.14−$54.25
  5. Manhattan, NY · New York$441.70−$2.69
  6. Alaska · Alaska$423.57−$20.82
  7. Alabama · Alabama$338.37−$106.02

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

78454 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$332.79—
ArizonaArizona$371.09—
Bakersfield, CACalifornia$413.14—
Chico, CACalifornia$412.71—
El Centro, CACalifornia$412.74—
Fresno, CACalifornia$412.71—
Hanford, CACalifornia$412.71—
Madera, CACalifornia$412.71—

78454 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.

$332.79

$472.47

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

View every state and territory as a table
78454 office rate range by state
State / territoryOffice rate rangeLocalities
AK$423.571
AL$338.371
AR$332.791
AZ$371.091
CA$412.71–$532.2329
CO$402.961
CT$409.661
DC$444.391
DE$377.851
FL$369.78–$402.943
GA$346.97–$388.522
GU$425.851
HI$425.851
IA$350.921
ID$352.951
IL$355.71–$395.034
IN$355.341
KS$347.751
KY$344.671
LA$343.54–$363.062
MA$399.54–$448.122
MD$386.16–$444.393
ME$353.64–$377.382
MI$353.68–$373.642
MN$388.491
MO$335.94–$366.103
MS$334.511
MT$382.101
NC$358.061
ND$379.331
NE$353.501
NH$395.201
NJ$415.01–$438.572
NM$355.351
NV$381.661
NY$364.03–$451.985
OH$353.111
OK$345.361
OR$379.38–$418.652
PA$354.49–$397.482
PR$385.711
RI$393.441
SC$356.051
SD$379.001
TN$349.581
TX$351.74–$401.018
UT$361.611
VA$375.06–$444.392
VI$385.711
VT$376.461
WA$399.24–$459.182
WI$364.861
WV$340.411
WY$380.891

See 78454 in every payment locality

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.

How the rate is built · 78454

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.31

1.31 RVUs× 1.000 GPCI

Practice expense9.99

9.99 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

11.4400

Conversion factor

$33.4009

Medicare rate

$382.11

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,374

Code
78454
Physician work
1.31
Practice expense
9.99
Malpractice
0.14

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 78454 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.31× 1.0541.3807
Practice expense9.99× 1.17811.7682
Malpractice0.14× 1.1130.1558
Total RVUs13.3048
Conversion factor× 33.4009

Office rate, Washington, DC area$444.39

Office: (1.31 × 1.054 + 9.99 × 1.178 + 0.14 × 1.113) × $33.4009 = $444.39

Open 78454 in the RVU calculator

Payment rules and modifiers for 78454

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

CMS payment indicators · 78454

Heart imaging, multiple planar 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

78454 without 26 · national office

$382.11

Heart imaging, multiple planar studies

78454-26 · Professional component

$61.12

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78454

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

Codes related to 78454
CodeHow it relatesOffice range, Washington, DC area
Same family
78453Heart perfusion imaging, single planar studyPlanar myocardial imaging for a single study.$305.38
Used instead
78452Nuclear stress test, SPECT, multiple perfusion studiesMultiple-study myocardial imaging using SPECT rather than planar acquisition.$497.20
78451Cardiac SPECT, single rest or stress studySingle-study myocardial imaging using SPECT rather than planar acquisition.$360.90

How 78454 has changed in Washington, DC area

78454 · Office / nonfacility

$444.39

Effective 2026-10-01

The base rate is $1.17 lower than on 2025-10-01, moving from $445.56 to $444.39 (0.3%).

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

    $445.56changed to$444.39

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.34 changed to 1.31
    • Practice expense RVU 10.25 changed to 9.99
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $467.63changed to$445.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.46 changed to 10.25
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $460.00changed to$467.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $493.57changed to$460.00

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.69 changed to 10.46
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $517.52changed to$493.57

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.81 changed to 10.69
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $540.71changed to$517.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.29 changed to 10.81
    • Malpractice RVU 0.10 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $539.22changed to$540.71

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.96 changed to 11.29
    • Malpractice RVU 0.12 changed to 0.10
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $537.96changed to$539.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.10 changed to 10.96
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $548.22changed to$537.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.35 changed to 11.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $544.55changed to$548.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.30 changed to 11.35
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $542.59changed to$544.55

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.28 changed to 11.30
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $540.14changed to$542.59

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.21 changed to 11.28
    • Malpractice RVU 0.09 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $537.45changed to$540.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $528.37changed to$537.45

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.01 changed to 11.21
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $532.25changed to$528.37

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.80 changed to 11.01
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $532.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$444.39Not available in this settingRVU26D
2026-07-01$444.39Not available in this settingRVU26C
2026-04-01$444.39Not available in this settingRVU26B
2026-01-01$444.39Not available in this settingRVU26A
2025-10-01$445.56Not available in this settingRVU25D
2025-07-01$445.56Not available in this settingRVU25C
2025-04-01$445.56Not available in this settingRVU25B
2025-01-01$445.56Not available in this settingRVU25A
2024-10-01$467.63Not available in this settingRVU24D
2024-07-01$467.63Not available in this settingRVU24C
2024-04-01$467.63Not available in this settingRVU24B
2024-03-09$467.63Not available in this settingRVU24AR
2024-01-01$460.00Not available in this settingRVU24A
2023-10-01$493.57Not available in this settingRVU23D
2023-07-01$493.57Not available in this settingRVU23C
2023-04-01$493.57Not available in this settingRVU23B
2023-01-01$493.57Not available in this settingRVU23A
2022-10-01$517.52Not available in this settingRVU22D
2022-07-01$517.52Not available in this settingRVU22C
2022-04-01$517.52Not available in this settingRVU22B
2022-01-01$517.52Not available in this settingRVU22A
2021-10-01$540.71Not available in this settingRVU21D
2021-07-01$540.71Not available in this settingRVU21C
2021-04-01$540.71Not available in this settingRVU21B
2021-01-01$540.71Not available in this settingRVU21A
2020-10-01$539.22Not available in this settingRVU20D
2020-07-01$539.22Not available in this settingRVU20C
2020-04-01$539.22Not available in this settingRVU20B
2020-01-01$539.22Not available in this settingRVU20A
2019-10-01$537.96Not available in this settingRVU19D
2019-07-01$537.96Not available in this settingRVU19C
2019-04-01$537.96Not available in this settingRVU19B
2019-01-01$537.96Not available in this settingRVU19A
2018-10-01$548.22Not available in this settingRVU18D
2018-07-01$548.22Not available in this settingRVU18C
2018-04-01$548.22Not available in this settingRVU18B
2018-01-01$548.22Not available in this settingRVU18AR1
2017-10-01$544.55Not available in this settingRVU17D
2017-07-01$544.55Not available in this settingRVU17C
2017-04-01$544.55Not available in this settingRVU17B
2017-01-01$544.55Not available in this settingRVU17A
2016-10-01$542.59Not available in this settingRVU16D
2016-07-01$542.59Not available in this settingRVU16C
2016-04-01$542.59Not available in this settingRVU16B
2016-01-01$542.59Not available in this settingRVU16A
2015-10-01$540.14Not available in this settingRVU15D
2015-07-01$540.14Not available in this settingRVU15C
2015-04-01$537.45Not available in this settingRVU15B
2015-01-01$537.45Not available in this settingRVU15A
2014-10-01$528.37Not available in this settingRVU14D
2014-07-01$528.37Not available in this settingRVU14C
2014-04-01$528.37Not available in this settingRVU14B
2014-01-01$528.37Not available in this settingRVU14A
2013-10-01$532.25Not available in this settingRVU13D
2013-07-01$532.25Not available in this settingRVU13C
2013-04-01$532.25Not available in this settingRVU13B
2013-01-01$532.25Not available in this settingRVU13AR

Price 78454 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

78454 billing questions

How does this differ from 78453?

Both describe planar myocardial imaging. Use 78454 for multiple studies and 78453 for a single study.

When is 78452 a better fit?

78452 describes multiple-study myocardial imaging performed with SPECT. Choose 78454 when the acquisition is planar rather than tomographic.

Does multiple studies mean multiple planar views?

No. The distinction is the number of imaging studies, not simply the number of views or projections in one study.

How should the professional and technical portions be billed?

Use modifier 26 for the professional interpretation and modifier TC for the technical service. Bill without either modifier when billing the global service.

What does the cardiovascular diagnostic multiple-procedure reduction affect?

CMS applies the reduction to the technical component. It does not apply to the professional component.

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 78454PPRRVU2026_Oct_nonQPP.csv, line 9,374 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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