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

CMS doesn’t publish an office rate for 78492 in California.

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

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 in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

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.

Payment rules and modifiers for 78492

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

What modifiers do to the payment

When to use modifier 26

78492 compared with similar codes

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.

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