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

PET myocardial metabolic imaging assesses heart muscle metabolism, often to evaluate myocardial viability in people with coronary artery disease and impaired heart function.

CMS RVU26DEffective Oct 1, 2026One payment locality496 Medicare services in 2024

CMS doesn’t publish a rate for 78459 in Delaware.

Contractor-pricedOffice (non-facility)
Contractor-pricedHospital or facility

Check a contract rate as a % of Medicare · 78459 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 78459 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 78459 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 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.

How Delaware compares for 78459

78459 in Delaware vs other payment areas
  1. Delaware · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

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

Every other payment area

78459 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

78459 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.

View every state and territory as a table
78459 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 78459 in every payment locality

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.

How the rate is built · 78459

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 78459

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

CMS payment indicators · 78459

PET myocardial imaging, single metabolic study

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
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

78459 without 26 · national facility

$0.00

PET myocardial imaging, single metabolic study

78459-26 · Professional component

$70.81

Pays only the interpretation and report.

When to use modifier 26

How 78459 has changed in Delaware

78459 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Contractor-pricedContractor-pricedRVU26D
2026-07-01Contractor-pricedContractor-pricedRVU26C
2026-04-01Contractor-pricedContractor-pricedRVU26B
2026-01-01Contractor-pricedContractor-pricedRVU26A
2025-10-01Contractor-pricedContractor-pricedRVU25D
2025-07-01Contractor-pricedContractor-pricedRVU25C
2025-04-01Contractor-pricedContractor-pricedRVU25B
2025-01-01Contractor-pricedContractor-pricedRVU25A
2024-10-01Contractor-pricedContractor-pricedRVU24D
2024-07-01Contractor-pricedContractor-pricedRVU24C
2024-04-01Contractor-pricedContractor-pricedRVU24B
2024-03-09Contractor-pricedContractor-pricedRVU24AR
2024-01-01Contractor-pricedContractor-pricedRVU24A
2023-10-01Contractor-pricedContractor-pricedRVU23D
2023-07-01Contractor-pricedContractor-pricedRVU23C
2023-04-01Contractor-pricedContractor-pricedRVU23B
2023-01-01Contractor-pricedContractor-pricedRVU23A
2022-10-01Contractor-pricedContractor-pricedRVU22D
2022-07-01Contractor-pricedContractor-pricedRVU22C
2022-04-01Contractor-pricedContractor-pricedRVU22B
2022-01-01Contractor-pricedContractor-pricedRVU22A
2021-10-01Contractor-pricedContractor-pricedRVU21D
2021-07-01Contractor-pricedContractor-pricedRVU21C
2021-04-01Contractor-pricedContractor-pricedRVU21B
2021-01-01Contractor-pricedContractor-pricedRVU21A
2020-10-01Contractor-pricedContractor-pricedRVU20D
2020-07-01Contractor-pricedContractor-pricedRVU20C
2020-04-01Contractor-pricedContractor-pricedRVU20B
2020-01-01Contractor-pricedContractor-pricedRVU20A
2019-10-01Contractor-pricedContractor-pricedRVU19D
2019-07-01Contractor-pricedContractor-pricedRVU19C
2019-04-01Contractor-pricedContractor-pricedRVU19B
2019-01-01Contractor-pricedContractor-pricedRVU19A
2018-10-01Contractor-pricedContractor-pricedRVU18D
2018-07-01Contractor-pricedContractor-pricedRVU18C
2018-04-01Contractor-pricedContractor-pricedRVU18B
2018-01-01Contractor-pricedContractor-pricedRVU18AR1
2017-10-01Contractor-pricedContractor-pricedRVU17D
2017-07-01Contractor-pricedContractor-pricedRVU17C
2017-04-01Contractor-pricedContractor-pricedRVU17B
2017-01-01Contractor-pricedContractor-pricedRVU17A
2016-10-01Contractor-pricedContractor-pricedRVU16D
2016-07-01Contractor-pricedContractor-pricedRVU16C
2016-04-01Contractor-pricedContractor-pricedRVU16B
2016-01-01Contractor-pricedContractor-pricedRVU16A
2015-10-01Contractor-pricedContractor-pricedRVU15D
2015-07-01Contractor-pricedContractor-pricedRVU15C
2015-04-01Contractor-pricedContractor-pricedRVU15B
2015-01-01Contractor-pricedContractor-pricedRVU15A
2014-10-01Contractor-pricedContractor-pricedRVU14D
2014-07-01Contractor-pricedContractor-pricedRVU14C
2014-04-01Contractor-pricedContractor-pricedRVU14B
2014-01-01Contractor-pricedContractor-pricedRVU14A
2013-10-01Contractor-pricedContractor-pricedRVU13D
2013-07-01Contractor-pricedContractor-pricedRVU13C
2013-04-01Contractor-pricedContractor-pricedRVU13B
2013-01-01Contractor-pricedContractor-pricedRVU13AR

Price 78459 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

78459 billing questions

How does this differ from PET myocardial perfusion imaging?

This code represents metabolic evaluation of the heart muscle, often for viability assessment. Codes 78491 and 78492 describe PET myocardial perfusion studies.

When should modifier 26 or TC be used?

Use modifier 26 for the physician's interpretation and modifier TC for the technical portion. Report the global service without either modifier.

How many studies does this code describe?

It describes a single PET myocardial metabolic study, rather than multiple rest and stress perfusion studies.

How does Medicare price this service?

The physician fee schedule status is C. The Medicare Administrative Contractor sets payment for each claim; CMS publishes no national payment for this code.

Is a CT acquisition included in this code?

This code does not identify a CT acquisition. Code 78429 is the related metabolic-evaluation option that includes concurrently acquired CT.

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

Did this answer your question about what 78459 pays in Delaware?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 78459 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist