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CPT code 78494: Cardiac blood-pool imaging, gated SPECT2026 Medicare rate & RVUs in Washington, DC area

Reports ECG-gated SPECT imaging of the cardiac blood pool to assess ventricular function and wall motion rather than myocardial perfusion.

CMS RVU26DEffective Oct 1, 2026One payment locality324 Medicare services in 2024

In Washington, DC area, Medicare pays $243.67 for 78494 in the office.

$243.67Office (non-facility)
Not available in this settingHospital or facility
+15.4%vs the national office rate ($211.09)

Check a contract rate as a % of Medicare · 78494 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 78494 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 78494 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 78494 covers

This study uses a radiotracer in the circulating blood and ECG gating to create tomographic images of the heart across the cardiac cycle. It helps assess ventricular function and wall motion, including left ventricular function monitoring in patients receiving potentially cardiotoxic chemotherapy. Nuclear medicine physicians or other qualified imaging professionals typically perform and interpret the study in hospital or outpatient imaging settings. Unlike myocardial perfusion SPECT, it images the blood pool rather than tracer uptake in heart muscle.

Report 78494 when the documented acquisition is gated equilibrium cardiac blood-pool SPECT. The record should support the cardiac indication, the SPECT blood-pool technique, and the physician’s interpretation. The code has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component when the rule applies; it does not reduce the professional component under this rule.

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 Washington, DC area compares for 78494

Across 109 of 109 payment localities, the office rate for 78494 runs from $185.76 in Arkansas to $288.81 in San Benito County, CA. Washington, DC area pays $243.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

78494 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$243.67
  2. Los Angeles, CA · California$242.66−$1.01
  3. Miami, FL · Florida$222.63−$21.04
  4. Chicago, IL · Illinois$216.10−$27.57
  5. Manhattan, NY · New York$242.77−$0.90
  6. Alaska · Alaska$240.12−$3.55
  7. Alabama · Alabama$188.62−$55.05

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

78494 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$185.76—
ArizonaArizona$205.41—
Bakersfield, CACalifornia$226.91—
Chico, CACalifornia$226.61—
El Centro, CACalifornia$226.63—
Fresno, CACalifornia$226.61—
Hanford, CACalifornia$226.61—
Madera, CACalifornia$226.61—

78494 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.

$185.76

$257.71

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

View every state and territory as a table
78494 office rate range by state
State / territoryOffice rate rangeLocalities
AK$240.121
AL$188.621
AR$185.761
AZ$205.411
CA$226.61–$288.8129
CO$221.741
CT$225.541
DC$243.671
DE$208.951
FL$205.15–$222.633
GA$193.38–$214.522
GU$233.031
HI$233.031
IA$194.891
ID$195.961
IL$198.05–$218.264
IN$197.191
KS$193.351
KY$192.041
LA$191.49–$201.512
MA$220.08–$245.202
MD$213.27–$243.673
ME$196.41–$208.462
MI$196.75–$207.232
MN$213.891
MO$187.65–$202.973
MS$186.771
MT$211.091
NC$198.661
ND$209.311
NE$196.181
NH$217.661
NJ$228.51–$240.832
NM$197.641
NV$210.761
NY$201.73–$248.165
OH$196.381
OK$192.301
OR$209.52–$229.742
PA$197.04–$219.312
PR$212.911
RI$217.091
SC$197.771
SD$209.101
TN$194.291
TX$195.64–$220.658
UT$200.631
VA$207.33–$243.672
VI$212.911
VT$207.921
WA$219.85–$250.922
WI$201.901
WV$190.211
WY$210.311

See 78494 in every payment locality

How the 78494 rate is calculated

Each of 78494’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 · 78494

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.16

1.16 RVUs× 1.000 GPCI

Practice expense5.07

5.07 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

6.3200

Conversion factor

$33.4009

Medicare rate

$211.09

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

9,416

Code
78494
Physician work
1.16
Practice expense
5.07
Malpractice
0.09

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 78494 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.16× 1.0541.2226
Practice expense5.07× 1.1785.9725
Malpractice0.09× 1.1130.1002
Total RVUs7.2953
Conversion factor× 33.4009

Office rate, Washington, DC area$243.67

Office: (1.16 × 1.054 + 5.07 × 1.178 + 0.09 × 1.113) × $33.4009 = $243.67

Open 78494 in the RVU calculator

Payment rules and modifiers for 78494

The CMS indicators that decide how 78494 is paid alongside other services.

CMS payment indicators · 78494

Cardiac blood-pool imaging, gated SPECT

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

78494 without 26 · national office

$211.09

Cardiac blood-pool imaging, gated SPECT

78494-26 · Professional component

$54.44

Pays only the interpretation and report.

When to use modifier 26

Codes related to 78494

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

Codes related to 78494
CodeHow it relatesOffice range, Washington, DC area
Same family
78472Cardiac blood-pool imaging, single planar equilibrium studyGated equilibrium blood-pool imaging performed with planar rather than SPECT acquisition.$240.19
78473Gated heart imaging, multiple studiesMultiple-study planar gated equilibrium blood-pool imaging.$308.22
Used instead
78481Cardiac function imaging, single first-pass studyFirst-pass blood-pool imaging is a different acquisition method for assessing cardiac function.$187.14
78483First-pass cardiac imaging, multiple studiesMultiple-study first-pass blood-pool imaging uses a different acquisition method.$252.41
78451Cardiac SPECT, single rest or stress studySingle-study myocardial perfusion SPECT images heart-muscle perfusion rather than the blood pool.$360.90
78452Nuclear stress test, SPECT, multiple perfusion studiesMultiple-study myocardial perfusion SPECT evaluates heart-muscle perfusion, not blood-pool function.$497.20

How 78494 has changed in Washington, DC area

78494 · Office / nonfacility

$243.67

Effective 2026-10-01

The base rate is $7.18 higher than on 2025-10-01, moving from $236.49 to $243.67 (3.0%).

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

    $236.49changed to$243.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.19 changed to 1.16
    • Practice expense RVU 5.00 changed to 5.07
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $246.94changed to$236.49

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.09 changed to 5.00

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $242.91changed to$246.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $257.38changed to$242.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.14 changed to 5.09
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $271.55changed to$257.38

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.25 changed to 5.14
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $281.99changed to$271.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.44 changed to 5.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $277.92changed to$281.99

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.18 changed to 5.44
    • Malpractice RVU 0.10 changed to 0.08
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $276.01changed to$277.92

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.24 changed to 5.18
    • Malpractice RVU 0.08 changed to 0.10
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $279.18changed to$276.01

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.32 changed to 5.24

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $276.31changed to$279.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.27 changed to 5.32
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $275.82changed to$276.31

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $274.62changed to$275.82

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.23 changed to 5.27
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $273.25changed to$274.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $272.12changed to$273.25

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.21 changed to 5.23
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $277.08changed to$272.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.69 changed to 5.21
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $277.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$243.67Not available in this settingRVU26D
2026-07-01$243.67Not available in this settingRVU26C
2026-04-01$243.67Not available in this settingRVU26B
2026-01-01$243.67Not available in this settingRVU26A
2025-10-01$236.49Not available in this settingRVU25D
2025-07-01$236.49Not available in this settingRVU25C
2025-04-01$236.49Not available in this settingRVU25B
2025-01-01$236.49Not available in this settingRVU25A
2024-10-01$246.94Not available in this settingRVU24D
2024-07-01$246.94Not available in this settingRVU24C
2024-04-01$246.94Not available in this settingRVU24B
2024-03-09$246.94Not available in this settingRVU24AR
2024-01-01$242.91Not available in this settingRVU24A
2023-10-01$257.38Not available in this settingRVU23D
2023-07-01$257.38Not available in this settingRVU23C
2023-04-01$257.38Not available in this settingRVU23B
2023-01-01$257.38Not available in this settingRVU23A
2022-10-01$271.55Not available in this settingRVU22D
2022-07-01$271.55Not available in this settingRVU22C
2022-04-01$271.55Not available in this settingRVU22B
2022-01-01$271.55Not available in this settingRVU22A
2021-10-01$281.99Not available in this settingRVU21D
2021-07-01$281.99Not available in this settingRVU21C
2021-04-01$281.99Not available in this settingRVU21B
2021-01-01$281.99Not available in this settingRVU21A
2020-10-01$277.92Not available in this settingRVU20D
2020-07-01$277.92Not available in this settingRVU20C
2020-04-01$277.92Not available in this settingRVU20B
2020-01-01$277.92Not available in this settingRVU20A
2019-10-01$276.01Not available in this settingRVU19D
2019-07-01$276.01Not available in this settingRVU19C
2019-04-01$276.01Not available in this settingRVU19B
2019-01-01$276.01Not available in this settingRVU19A
2018-10-01$279.18Not available in this settingRVU18D
2018-07-01$279.18Not available in this settingRVU18C
2018-04-01$279.18Not available in this settingRVU18B
2018-01-01$279.18Not available in this settingRVU18AR1
2017-10-01$276.31Not available in this settingRVU17D
2017-07-01$276.31Not available in this settingRVU17C
2017-04-01$276.31Not available in this settingRVU17B
2017-01-01$276.31Not available in this settingRVU17A
2016-10-01$275.82Not available in this settingRVU16D
2016-07-01$275.82Not available in this settingRVU16C
2016-04-01$275.82Not available in this settingRVU16B
2016-01-01$275.82Not available in this settingRVU16A
2015-10-01$274.62Not available in this settingRVU15D
2015-07-01$274.62Not available in this settingRVU15C
2015-04-01$273.25Not available in this settingRVU15B
2015-01-01$273.25Not available in this settingRVU15A
2014-10-01$272.12Not available in this settingRVU14D
2014-07-01$272.12Not available in this settingRVU14C
2014-04-01$272.12Not available in this settingRVU14B
2014-01-01$272.12Not available in this settingRVU14A
2013-10-01$277.08Not available in this settingRVU13D
2013-07-01$277.08Not available in this settingRVU13C
2013-04-01$277.08Not available in this settingRVU13B
2013-01-01$277.08Not available in this settingRVU13AR

Price 78494 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

78494 billing questions

How does 78494 differ from 78472?

78494 is for gated equilibrium SPECT blood-pool imaging. 78472 is the planar version for a single study.

Is this a myocardial perfusion study?

No. It images the cardiac blood pool to evaluate ventricular function and wall motion. Codes 78451 and 78452 describe myocardial perfusion SPECT.

When should modifier 26 or TC be used?

Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Report without either modifier when billing the global service.

Which part is subject to the multiple-procedure reduction?

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

What documentation supports reporting 78494?

Document the indication, gated equilibrium blood-pool SPECT technique, and interpretation. The record should distinguish this acquisition from planar or first-pass imaging.

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 78494PPRRVU2026_Oct_nonQPP.csv, line 9,416 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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