CPT code 78459: PET myocardial imaging, single metabolic study2026 Medicare rate & RVUs in Missouri
PET myocardial metabolic imaging assesses heart muscle metabolism, often to evaluate myocardial viability in people with coronary artery disease and impaired heart function.
CMS doesn’t publish an office rate for 78459 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
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.
78459 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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