FeeBase
Log inGet started
Menu

CPT code 78491: Myocardial PET, single study2026 Medicare rate & RVUs

Reports one PET myocardial perfusion study performed at rest or under stress to evaluate blood flow through the heart muscle.

CMS RVU26DEffective Oct 1, 2026109 payment localities112 Medicare services in 2024

Medicare rate · 78491

Myocardial PET, single study

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 78491 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 78491 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78491 covers

This code represents PET imaging of myocardial perfusion during one study, performed either at rest or under stress. Nuclear medicine and cardiac imaging teams acquire the images after administering a radiopharmaceutical tracer. Clinicians use myocardial perfusion imaging to assess blood flow to the heart muscle, including when evaluating suspected or known coronary artery disease. The study may be performed in a hospital or an imaging practice equipped for cardiac PET.

Medicare assigns status C, meaning there is no national physician fee schedule payment and the Medicare Administrative Contractor prices the claim. The service has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies the equipment and staff portion, and no modifier represents the global service. The code represents a single study, not separate rest and stress studies.

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 78491 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

78491 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

78491 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.

View every state and territory as a table
78491 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

How the 78491 rate is calculated

Each of 78491’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 · 78491

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 78491

The CMS indicators that decide how 78491 is paid alongside other services.

CMS payment indicators · 78491

Myocardial PET, single 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

78491 without 26 · national facility

$0.00

Myocardial PET, single study

78491-26 · Professional component

$70.81

Pays only the interpretation and report.

When to use modifier 26

78491 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 78491

    Myocardial PET, single study0 wRVU

    Not priced

  • 78492

    PET perfusion, multiple studies0 wRVU

    Not priced

  • 78431

    Cardiac PET, rest and stress with CT0 wRVU

    Not priced

  • 78451

    Cardiac SPECT, single rest or stress study1.35 wRVU

    $311.30

  • 78452

    Nuclear stress test, SPECT, multiple perfusion studies1.58 wRVU

    $427.87

How to choose

78492PET perfusionMultiple studies
78491 represents one PET perfusion study at rest or stress; 78492 represents PET perfusion studies at both rest and stress.
78431Cardiac PETRest and stress with CT
78431 covers PET perfusion at rest and stress with a concurrently acquired CT scan. 78491 is for a single study at rest or stress.
78451Cardiac SPECTSingle rest or stress study
78451 is a single-study myocardial perfusion code using SPECT. Use 78491 when the imaging method is PET.
78452Nuclear stress testSPECT, multiple perfusion studies
78452 describes multiple-study SPECT myocardial perfusion imaging. 78491 describes one PET myocardial perfusion study.

Codes related to 78491

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

Codes related to 78491
CodeHow it relatesNational office range
Same family
78492PET perfusion, multiple studiesPET myocardial perfusion imaging for studies at both rest and stress.No office rate
Used instead
78431Cardiac PET, rest and stress with CTPET myocardial perfusion at rest and stress with concurrently acquired CT imaging.No office rate
78451Cardiac SPECT, single rest or stress studySPECT myocardial perfusion imaging for a single study.$272.61–$430.89
78452Nuclear stress test, SPECT, multiple perfusion studiesSPECT myocardial perfusion imaging for multiple studies.$373.48–$595.53

78491 billing questions

When should this code be used instead of 78492?

Use this code for a single PET perfusion study at rest or under stress. Code 78492 describes PET studies performed at both rest and stress.

How does this differ from 78431?

Code 78431 describes PET myocardial perfusion imaging at rest and stress with a concurrently acquired CT scan. This code is for one study at rest or stress.

Can the professional and technical portions be reported separately?

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

What does Medicare status C mean for this code?

CMS publishes no national physician fee schedule payment for this code. The Medicare Administrative Contractor prices each claim.

How does this PET study differ from SPECT codes 78451 and 78452?

This code describes PET imaging. Codes 78451 and 78452 describe myocardial perfusion imaging using SPECT; select the code matching the imaging method and study pattern.

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 78491 pays?

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 78491 and the rest of your codes on one sheet

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

Join the waitlist