CPT code 78491: Myocardial PET, single study2026 Medicare rate & RVUs in Missouri
Reports one PET myocardial perfusion study performed at rest or under stress to evaluate blood flow through the heart muscle.
CMS doesn’t publish an office rate for 78491 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 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 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 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
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
| 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
78491 without 26 · national facility
$0.00
Myocardial PET, single study
78491-26 · Professional component
$70.81
Pays only the interpretation and report.
78491 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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