CPT code 78459: PET myocardial imaging, single metabolic study2026 Medicare rate & RVUs

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

What 78459 covers

This study uses positron emission tomography to assess myocardial metabolism, commonly with a glucose-analogue radiotracer such as fluorodeoxyglucose. Cardiologists and nuclear medicine physicians use the images to evaluate whether heart muscle with impaired blood supply may remain viable, including in patients with coronary artery disease and reduced left ventricular function. Nuclear medicine staff perform the imaging in a hospital or outpatient imaging department, and a physician interprets the study.

Medicare assigns this code physician fee schedule status C: the Medicare Administrative Contractor sets payment for each claim, rather than CMS publishing a national payment. The study has professional and technical components. Modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff portion, and reporting without either modifier represents the global service.

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 78459 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

78459 rates by state

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

How the 78459 rate is calculated

Each of 78459’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 78459

The CMS indicators that decide how 78459 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78459 compared with similar codes

How to choose

78491Myocardial PETSingle study

Use 78491 for a single PET myocardial perfusion study at rest or stress. This code represents metabolic evaluation rather than perfusion imaging.

78492PET perfusionMultiple studies

Use 78492 for multiple PET myocardial perfusion studies at rest and/or stress. This code is for myocardial metabolic evaluation.

78429Cardiac PETSingle metabolic study with CT

Both represent PET myocardial metabolic evaluation, but 78429 includes concurrently acquired CT for attenuation correction and anatomical localization.

Codes related to 78459

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