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CPT code 78492: PET perfusion, multiple studies2026 Medicare rate & RVUs

Reports multiple PET myocardial perfusion studies performed at rest and/or under stress to evaluate blood flow to the heart muscle.

CMS RVU26DEffective Oct 1, 2026109 payment localities77K Medicare services in 2024

Medicare rate · 78492

PET perfusion, multiple studies

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 78492 →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 78492 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 78492 covers

Code 78492 represents PET imaging of myocardial perfusion across multiple studies performed at rest and/or during cardiac stress. A radiotracer is administered, and PET images assess blood flow to the heart muscle. Stress may be exercise-induced or pharmacologically induced. Cardiologists, nuclear medicine physicians, and imaging departments report this service when evaluating suspected or established coronary artery disease or myocardial ischemia in office-based and hospital outpatient settings.

Medicare assigns this service physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Modifier 26 identifies the professional interpretation, modifier TC identifies the technical service, and reporting without either modifier represents the global service. When PET perfusion imaging includes a concurrently acquired CT transmission scan, 78431 is the related code.

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 78492 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

78492 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

78492 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
78492 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 78492 rate is calculated

Each of 78492’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 · 78492

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 78492

The CMS indicators that decide how 78492 is paid alongside other services.

CMS payment indicators · 78492

PET perfusion, multiple studies

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

78492 without 26 · national facility

$0.00

PET perfusion, multiple studies

78492-26 · Professional component

$82.50

Pays only the interpretation and report.

When to use modifier 26

78492 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 78492

    PET perfusion, multiple studies0 wRVU

    Not priced

  • 78491

    Myocardial PET, single study0 wRVU

    Not priced

  • 78431

    Cardiac PET, rest and stress with CT0 wRVU

    Not priced

  • 78452

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

    $427.87

How to choose

78491Myocardial PETSingle study
Choose 78491 for a single PET perfusion study at rest or stress; 78492 represents multiple PET perfusion studies.
78431Cardiac PETRest and stress with CT
78431 describes multiple-study PET perfusion imaging with a concurrently acquired CT transmission scan. 78492 identifies PET perfusion imaging without that CT feature in its code definition.
78452Nuclear stress testSPECT, multiple perfusion studies
Both describe multiple-study myocardial perfusion imaging, but 78452 uses SPECT and 78492 uses PET.

Codes related to 78492

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

Codes related to 78492
CodeHow it relatesNational office range
Same family
78491Myocardial PET, single studyPET myocardial perfusion code for a single study at rest or stress.No office rate
Used instead
78431Cardiac PET, rest and stress with CTMultiple-study PET perfusion imaging with a concurrently acquired CT transmission scan.No office rate
78432Myocardial PET, two radiopharmaceuticalsPET myocardial perfusion imaging using two radiotracers.No office rate
78451Cardiac SPECT, single rest or stress studySingle-study myocardial perfusion imaging using SPECT rather than PET.$272.61–$430.89
78452Nuclear stress test, SPECT, multiple perfusion studiesMultiple-study myocardial perfusion imaging using SPECT rather than PET.$373.48–$595.53

78492 billing questions

How does 78492 differ from 78491?

78492 is for multiple PET perfusion studies at rest and/or stress. 78491 is for a single PET perfusion study at rest or stress.

When should 78431 be considered instead?

78431 describes multiple-study PET myocardial perfusion imaging with a concurrently acquired CT transmission scan. Use it when that CT acquisition is part of the service.

Can the professional and technical services 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.

How does Medicare price 78492?

Medicare assigns status C, carrier priced. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

What should the record support?

Document the PET myocardial perfusion service and whether the studies were performed at rest, under stress, or both. The record should also support the professional, technical, or global service billed.

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

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