CPT code 78481: Cardiac function imaging, single first-pass study2026 Medicare rate & RVUs in North Carolina

Reports one radionuclide first-pass cardiac function study, using sequential images to evaluate ventricular motion and ejection fraction.

CMS RVU26DEffective Oct 1, 2026One payment locality639 Medicare services in 2024

In North Carolina, Medicare pays $153.11 for 78481 in the office.

$153.11Office (non-facility)
Not available in this settingHospital or facility
−5.7%vs the national office rate ($162.33)

Check a contract rate as a % of Medicare · 78481 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 78481 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 78481 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 78481 covers

A radiopharmaceutical bolus is followed as it moves through the heart, with rapid image acquisition during its first passage through the cardiac chambers. The resulting study supports quantitative assessment of cardiac function, including wall motion and ejection fraction. Nuclear medicine physicians, radiologists, or cardiologists may perform and interpret the examination in an imaging department or hospital setting, with or without pharmacologic intervention.

Report 78481 for a single first-pass study, rather than a series of first-pass studies. Documentation should identify the study performed and include the image interpretation and quantitative findings. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. When multiple cardiovascular diagnostic procedures are performed, CMS applies the multiple-procedure reduction to the technical component.

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 North Carolina compares for 78481

Across 109 of 109 payment localities, the office rate for 78481 runs from $143.39 in Arkansas to $221.92 in San Benito County, CA. North Carolina pays $153.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

78481 in North Carolina vs other payment areas
  1. North Carolina · this page$153.11
  2. Los Angeles, CA · California$186.61+$33.50
  3. Washington, DC area · District of Columbia$187.14+$34.03
  4. Miami, FL · Florida$170.15+$17.04
  5. Chicago, IL · Illinois$165.36+$12.25
  6. Manhattan, NY · New York$186.19+$33.08
  7. Alaska · Alaska$185.97+$32.86

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

Every other payment area

78481 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$145.53—
ArkansasArkansas$143.39—
ArizonaArizona$158.10—
Bakersfield, CACalifornia$174.63—
Chico, CACalifornia$174.44—
El Centro, CACalifornia$174.45—
Fresno, CACalifornia$174.44—
Hanford, CACalifornia$174.44—

78481 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.

$143.39

$198.18

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

View every state and territory as a table
78481 office rate range by state
State / territoryOffice rate rangeLocalities
AK$185.971
AL$145.531
AR$143.391
AZ$158.101
CA$174.44–$221.9229
CO$170.581
CT$173.221
DC$187.141
DE$160.781
FL$157.51–$170.153
GA$148.76–$164.822
GU$179.241
HI$179.241
IA$150.391
ID$151.161
IL$152.08–$167.314
IN$152.081
KS$149.161
KY$147.911
LA$147.47–$154.972
MA$169.32–$188.412
MD$164.06–$187.143
ME$151.41–$160.552
MI$151.36–$158.972
MN$164.881
MO$144.54–$156.163
MS$144.021
MT$162.331
NC$153.111
ND$161.341
NE$151.391
NH$167.391
NJ$175.60–$185.042
NM$151.991
NV$162.181
NY$155.40–$190.125
OH$151.151
OK$148.201
OR$161.32–$176.692
PA$151.69–$168.502
PR$163.721
RI$167.001
SC$152.301
SD$161.221
TN$149.851
TX$150.64–$169.668
UT$154.441
VA$159.65–$187.142
VI$163.721
VT$160.221
WA$169.16–$192.822
WI$155.771
WV$146.201
WY$161.891

See 78481 in every payment locality

How the 78481 rate is calculated

Each of 78481’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 · 78481

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.96

0.96 RVUs× 1.000 GPCI

Practice expense3.85

3.85 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

4.8600

Conversion factor

$33.4009

Medicare rate

$162.33

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,404

Code
78481
Physician work
0.96
Practice expense
3.85
Malpractice
0.05

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 78481 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.96× 1.0000.9600
Practice expense3.85× 0.9333.5921
Malpractice0.05× 0.6390.0319
Total RVUs4.5840
Conversion factor× 33.4009

Office rate, North Carolina$153.11

Office: (0.96 × 1 + 3.85 × 0.933 + 0.05 × 0.639) × $33.4009 = $153.11

Open 78481 in the RVU calculator

Payment rules and modifiers for 78481

The CMS indicators that decide how 78481 is paid alongside other services.

CMS payment indicators · 78481

Cardiac function imaging, single first-pass study

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

78481 without 26 · national office

$162.33

Cardiac function imaging, single first-pass study

78481-26 · Professional component

$44.42

Pays only the interpretation and report.

When to use modifier 26

How 78481 has changed in North Carolina

78481 · Office / nonfacility

$153.11

Effective 2026-10-01

The base rate is $6.60 higher than on 2025-10-01, moving from $146.51 to $153.11 (4.5%).

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

    $146.51changed to$153.11

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.98 changed to 0.96
    • Practice expense RVU 3.79 changed to 3.85
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $154.69changed to$146.51

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.91 changed to 3.79
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $152.17changed to$154.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $158.68changed to$152.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.93 changed to 3.91
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $164.96changed to$158.68

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.01 changed to 3.93
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $170.86changed to$164.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.15 changed to 4.01

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $170.80changed to$170.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.97 changed to 4.15
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $171.62changed to$170.80

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.01 changed to 3.97
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $173.52changed to$171.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.08 changed to 4.01
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $172.07changed to$173.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.05 changed to 4.08
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $170.93changed to$172.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.03 changed to 4.05
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $171.27changed to$170.93

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.05 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $170.42changed to$171.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $169.61changed to$170.42

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.01 changed to 4.03
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $176.22changed to$169.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.50 changed to 4.01
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $176.22

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$153.11Not available in this settingRVU26D
2026-07-01$153.11Not available in this settingRVU26C
2026-04-01$153.11Not available in this settingRVU26B
2026-01-01$153.11Not available in this settingRVU26A
2025-10-01$146.51Not available in this settingRVU25D
2025-07-01$146.51Not available in this settingRVU25C
2025-04-01$146.51Not available in this settingRVU25B
2025-01-01$146.51Not available in this settingRVU25A
2024-10-01$154.69Not available in this settingRVU24D
2024-07-01$154.69Not available in this settingRVU24C
2024-04-01$154.69Not available in this settingRVU24B
2024-03-09$154.69Not available in this settingRVU24AR
2024-01-01$152.17Not available in this settingRVU24A
2023-10-01$158.68Not available in this settingRVU23D
2023-07-01$158.68Not available in this settingRVU23C
2023-04-01$158.68Not available in this settingRVU23B
2023-01-01$158.68Not available in this settingRVU23A
2022-10-01$164.96Not available in this settingRVU22D
2022-07-01$164.96Not available in this settingRVU22C
2022-04-01$164.96Not available in this settingRVU22B
2022-01-01$164.96Not available in this settingRVU22A
2021-10-01$170.86Not available in this settingRVU21D
2021-07-01$170.86Not available in this settingRVU21C
2021-04-01$170.86Not available in this settingRVU21B
2021-01-01$170.86Not available in this settingRVU21A
2020-10-01$170.80Not available in this settingRVU20D
2020-07-01$170.80Not available in this settingRVU20C
2020-04-01$170.80Not available in this settingRVU20B
2020-01-01$170.80Not available in this settingRVU20A
2019-10-01$171.62Not available in this settingRVU19D
2019-07-01$171.62Not available in this settingRVU19C
2019-04-01$171.62Not available in this settingRVU19B
2019-01-01$171.62Not available in this settingRVU19A
2018-10-01$173.52Not available in this settingRVU18D
2018-07-01$173.52Not available in this settingRVU18C
2018-04-01$173.52Not available in this settingRVU18B
2018-01-01$173.52Not available in this settingRVU18AR1
2017-10-01$172.07Not available in this settingRVU17D
2017-07-01$172.07Not available in this settingRVU17C
2017-04-01$172.07Not available in this settingRVU17B
2017-01-01$172.07Not available in this settingRVU17A
2016-10-01$170.93Not available in this settingRVU16D
2016-07-01$170.93Not available in this settingRVU16C
2016-04-01$170.93Not available in this settingRVU16B
2016-01-01$170.93Not available in this settingRVU16A
2015-10-01$171.27Not available in this settingRVU15D
2015-07-01$171.27Not available in this settingRVU15C
2015-04-01$170.42Not available in this settingRVU15B
2015-01-01$170.42Not available in this settingRVU15A
2014-10-01$169.61Not available in this settingRVU14D
2014-07-01$169.61Not available in this settingRVU14C
2014-04-01$169.61Not available in this settingRVU14B
2014-01-01$169.61Not available in this settingRVU14A
2013-10-01$176.22Not available in this settingRVU13D
2013-07-01$176.22Not available in this settingRVU13C
2013-04-01$176.22Not available in this settingRVU13B
2013-01-01$176.22Not available in this settingRVU13AR

Price 78481 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

78481 billing questions

When is 78481 used instead of 78483?

Use 78481 for a single first-pass cardiac function study. Use 78483 when multiple first-pass studies are performed.

Can the interpretation and imaging be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

What happens when other cardiovascular diagnostic procedures are performed?

CMS applies its cardiovascular diagnostic multiple-procedure reduction to the technical component. The reduction does not apply to the professional component.

How does 78481 differ from a gated blood-pool study?

78481 follows the tracer during its first passage through the heart. Gated blood-pool imaging, such as 78472, uses a different acquisition approach.

What should the report document?

Document that a single first-pass study was performed, the interpretation, and quantitative findings such as wall motion and ejection fraction.

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 78481PPRRVU2026_Oct_nonQPP.csv, line 9,404 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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