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

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 Delaware, Medicare pays $208.95 for 78494 in the office.

$208.95Office (non-facility)
Not available in this settingHospital or facility
−1.0%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 Delaware
  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 Delaware 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. Delaware pays $208.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

78494 in Delaware vs other payment areas
  1. Delaware · this page$208.95
  2. Los Angeles, CA · California$242.66+$33.71
  3. Washington, DC area · District of Columbia$243.67+$34.72
  4. Miami, FL · Florida$222.63+$13.68
  5. Chicago, IL · Illinois$216.10+$7.15
  6. Manhattan, NY · New York$242.77+$33.82
  7. Alaska · Alaska$240.12+$31.17

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

78494 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$188.62—
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—

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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 78494 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.16× 1.0051.1658
Practice expense5.07× 0.9885.0092
Malpractice0.09× 0.8990.0809
Total RVUs6.2559
Conversion factor× 33.4009

Office rate, Delaware$208.95

Office: (1.16 × 1.005 + 5.07 × 0.988 + 0.09 × 0.899) × $33.4009 = $208.95

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, Delaware
Same family
78472Cardiac blood-pool imaging, single planar equilibrium studyGated equilibrium blood-pool imaging performed with planar rather than SPECT acquisition.$205.24
78473Gated heart imaging, multiple studiesMultiple-study planar gated equilibrium blood-pool imaging.$264.16
Used instead
78481Cardiac function imaging, single first-pass studyFirst-pass blood-pool imaging is a different acquisition method for assessing cardiac function.$160.78
78483First-pass cardiac imaging, multiple studiesMultiple-study first-pass blood-pool imaging uses a different acquisition method.$217.38
78451Cardiac SPECT, single rest or stress studySingle-study myocardial perfusion SPECT images heart-muscle perfusion rather than the blood pool.$308.03
78452Nuclear stress test, SPECT, multiple perfusion studiesMultiple-study myocardial perfusion SPECT evaluates heart-muscle perfusion, not blood-pool function.$423.24

How 78494 has changed in Delaware

78494 · Office / nonfacility

$208.95

Effective 2026-10-01

The base rate is $7.22 higher than on 2025-10-01, moving from $201.73 to $208.95 (3.6%).

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

    $201.73changed to$208.95

    • 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 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.57changed to$201.73

    • 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

    $207.14changed to$210.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $218.55changed to$207.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.14 changed to 5.09
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $229.63changed to$218.55

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.25 changed to 5.14
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $238.31changed to$229.63

    • 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

    $237.77changed to$238.31

    • 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 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $238.85changed to$237.77

    • 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 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $241.52changed to$238.85

    • 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

    $240.16changed to$241.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.27 changed to 5.32
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $240.76changed to$240.16

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $239.76changed to$240.76

    • 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

    $238.56changed to$239.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $239.07changed to$238.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.21 changed to 5.23
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $244.68changed to$239.07

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.69 changed to 5.21
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $244.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$208.95Not available in this settingRVU26D
2026-07-01$208.95Not available in this settingRVU26C
2026-04-01$208.95Not available in this settingRVU26B
2026-01-01$208.95Not available in this settingRVU26A
2025-10-01$201.73Not available in this settingRVU25D
2025-07-01$201.73Not available in this settingRVU25C
2025-04-01$201.73Not available in this settingRVU25B
2025-01-01$201.73Not available in this settingRVU25A
2024-10-01$210.57Not available in this settingRVU24D
2024-07-01$210.57Not available in this settingRVU24C
2024-04-01$210.57Not available in this settingRVU24B
2024-03-09$210.57Not available in this settingRVU24AR
2024-01-01$207.14Not available in this settingRVU24A
2023-10-01$218.55Not available in this settingRVU23D
2023-07-01$218.55Not available in this settingRVU23C
2023-04-01$218.55Not available in this settingRVU23B
2023-01-01$218.55Not available in this settingRVU23A
2022-10-01$229.63Not available in this settingRVU22D
2022-07-01$229.63Not available in this settingRVU22C
2022-04-01$229.63Not available in this settingRVU22B
2022-01-01$229.63Not available in this settingRVU22A
2021-10-01$238.31Not available in this settingRVU21D
2021-07-01$238.31Not available in this settingRVU21C
2021-04-01$238.31Not available in this settingRVU21B
2021-01-01$238.31Not available in this settingRVU21A
2020-10-01$237.77Not available in this settingRVU20D
2020-07-01$237.77Not available in this settingRVU20C
2020-04-01$237.77Not available in this settingRVU20B
2020-01-01$237.77Not available in this settingRVU20A
2019-10-01$238.85Not available in this settingRVU19D
2019-07-01$238.85Not available in this settingRVU19C
2019-04-01$238.85Not available in this settingRVU19B
2019-01-01$238.85Not available in this settingRVU19A
2018-10-01$241.52Not available in this settingRVU18D
2018-07-01$241.52Not available in this settingRVU18C
2018-04-01$241.52Not available in this settingRVU18B
2018-01-01$241.52Not available in this settingRVU18AR1
2017-10-01$240.16Not available in this settingRVU17D
2017-07-01$240.16Not available in this settingRVU17C
2017-04-01$240.16Not available in this settingRVU17B
2017-01-01$240.16Not available in this settingRVU17A
2016-10-01$240.76Not available in this settingRVU16D
2016-07-01$240.76Not available in this settingRVU16C
2016-04-01$240.76Not available in this settingRVU16B
2016-01-01$240.76Not available in this settingRVU16A
2015-10-01$239.76Not available in this settingRVU15D
2015-07-01$239.76Not available in this settingRVU15C
2015-04-01$238.56Not available in this settingRVU15B
2015-01-01$238.56Not available in this settingRVU15A
2014-10-01$239.07Not available in this settingRVU14D
2014-07-01$239.07Not available in this settingRVU14C
2014-04-01$239.07Not available in this settingRVU14B
2014-01-01$239.07Not available in this settingRVU14A
2013-10-01$244.68Not available in this settingRVU13D
2013-07-01$244.68Not available in this settingRVU13C
2013-04-01$244.68Not available in this settingRVU13B
2013-01-01$244.68Not available in this settingRVU13AR

Price 78494 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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