Billing code 78466: Infarct imagingMedicare rate & RVUs
Planar myocardial infarct imaging depicts uptake of an infarct-avid radiopharmaceutical to evaluate suspected myocardial injury, rather than myocardial perfusion.
Medicare pays $158.99 for 78466 nationally in the office. Local office rates run $138.92–$219.71.
Medicare rate · 78466
Infarct imaging
- Work RVUs
- 0.67
- Total RVUs
- 4.76
- Global days
- XXX
National rate · 2026
$158.99
Office setting, before claim adjustments.
See every locality for 78466 →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.
On this page 10 sections
What 78466 covers
This service is planar nuclear imaging that captures uptake of an infarct-avid radiopharmaceutical in the heart. It may be used to evaluate suspected myocardial injury; technetium-labeled pyrophosphate is a familiar example of an infarct-avid tracer. A nuclear medicine technologist performs the acquisition, and a nuclear medicine physician or other qualified physician interprets the images. The study is distinct from imaging designed to measure myocardial perfusion.
Report the code when the documented examination is planar infarct-avid imaging. The record should identify the imaging method and support the clinical question addressed; do not select it for a perfusion study or a tomographic infarct-avid study. Modifier 26 represents the physician’s interpretation, modifier TC represents the equipment and staff, and billing without either modifier represents the global service. When multiple cardiovascular diagnostic procedures are performed, the multiple-procedure reduction applies to the technical component.
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 78466 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$138.92 to $219.71
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $141.19 | Unavailable |
| Alaska* | $177.86 | Unavailable |
| Arizona | $154.49 | Unavailable |
| Arkansas | $138.92 | Unavailable |
| Atlanta | $161.67 | Unavailable |
| Austin | $166.55 | Unavailable |
| Bakersfield | $171.39 | Unavailable |
| Baltimore/Surr. Cntys | $169.70 | Unavailable |
| Beaumont | $146.74 | Unavailable |
| Brazoria | $157.44 | Unavailable |
| Chicago | $162.84 | Unavailable |
| Chico | $171.17 | Unavailable |
| Colorado | $167.34 | Unavailable |
| Connecticut | $170.27 | Unavailable |
| Dallas | $158.32 | Unavailable |
| Dc + Md/Va Suburbs | $184.36 | Unavailable |
| Delaware | $157.25 | Unavailable |
| Detroit | $155.89 | Unavailable |
| East St. Louis | $150.62 | Unavailable |
| El Centro | $171.19 | Unavailable |
| Fort Lauderdale | $162.62 | Unavailable |
| Fort Worth | $157.01 | Unavailable |
| Fresno | $171.17 | Unavailable |
| Galveston | $157.83 | Unavailable |
| Hanford-Corcoran | $171.17 | Unavailable |
| Hawaii, Guam | $176.40 | Unavailable |
| Houston | $159.11 | Unavailable |
| Idaho | $147.01 | Unavailable |
| Indiana | $147.98 | Unavailable |
| Iowa | $146.17 | Unavailable |
| Kansas | $144.94 | Unavailable |
| Kentucky | $143.89 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $183.69 | Unavailable |
| Madera | $171.17 | Unavailable |
| Manhattan | $183.54 | Unavailable |
| Merced | $171.17 | Unavailable |
| Metropolitan Boston | $185.70 | Unavailable |
| Metropolitan Kansas City | $150.74 | Unavailable |
| Metropolitan Philadelphia | $165.35 | Unavailable |
| Metropolitan St. Louis | $152.55 | Unavailable |
| Miami | $168.07 | Unavailable |
| Minnesota | $161.24 | Unavailable |
| Mississippi | $139.71 | Unavailable |
| Modesto | $171.17 | Unavailable |
| Montana** | $158.98 | Unavailable |
| Napa | $201.95 | Unavailable |
| Nebraska | $147.20 | Unavailable |
| Nevada** | $158.73 | Unavailable |
| New Hampshire | $164.20 | Unavailable |
| New Mexico | $148.31 | Unavailable |
| New Orleans | $151.38 | Unavailable |
| North Carolina | $149.15 | Unavailable |
| North Dakota** | $157.60 | Unavailable |
| Northern Nj | $182.04 | Unavailable |
| Nyc Suburbs/Long Island | $187.80 | Unavailable |
| Ohio | $147.33 | Unavailable |
| Oklahoma | $144.10 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $183.17 | Unavailable |
| Portland | $173.65 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $173.24 | Unavailable |
| Puerto Rico | $160.43 | Unavailable |
| Queens | $185.89 | Unavailable |
| Redding | $171.17 | Unavailable |
| Rest Of California | $171.17 | Unavailable |
| Rest Of Florida | $154.26 | Unavailable |
| Rest Of Georgia | $144.94 | Unavailable |
| Rest Of Illinois | $148.62 | Unavailable |
| Rest Of Louisiana | $143.45 | Unavailable |
| Rest Of Maine | $147.36 | Unavailable |
| Rest Of Maryland | $160.63 | Unavailable |
| Rest Of Massachusetts | $165.99 | Unavailable |
| Rest Of Michigan | $147.61 | Unavailable |
| Rest Of Missouri | $140.40 | Unavailable |
| Rest Of New Jersey | $172.46 | Unavailable |
| Rest Of New York | $151.58 | Unavailable |
| Rest Of Oregon | $157.76 | Unavailable |
| Rest Of Pennsylvania | $147.85 | Unavailable |
| Rest Of Texas | $151.91 | Unavailable |
| Rest Of Washington | $165.84 | Unavailable |
| Rhode Island | $163.59 | Unavailable |
| Riverside-San Bernardino-Ontario | $171.94 | Unavailable |
| Sacramento-Roseville-Folsom | $180.60 | Unavailable |
| Salinas | $179.95 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $184.91 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $214.90 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $214.82 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $219.71 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $219.39 | Unavailable |
| San Luis Obispo-Paso Robles | $176.95 | Unavailable |
| Santa Cruz-Watsonville | $187.24 | Unavailable |
| Santa Maria-Santa Barbara | $180.82 | Unavailable |
| Santa Rosa-Petaluma | $189.19 | Unavailable |
| Seattle (King Cnty) | $190.16 | Unavailable |
| South Carolina | $148.43 | Unavailable |
| South Dakota** | $157.44 | Unavailable |
| Southern Maine | $156.92 | Unavailable |
| Stockton | $171.17 | Unavailable |
| Suburban Chicago | $164.58 | Unavailable |
| Tennessee | $145.69 | Unavailable |
| Utah | $150.69 | Unavailable |
| Vallejo | $201.83 | Unavailable |
| Vermont | $156.49 | Unavailable |
| Virgin Islands | $160.43 | Unavailable |
| Virginia | $156.02 | Unavailable |
| Visalia | $171.17 | Unavailable |
| West Virginia | $142.41 | Unavailable |
| Wisconsin | $151.73 | Unavailable |
| Wyoming** | $158.38 | Unavailable |
| Yuba City | $171.17 | Unavailable |
78466 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$138.92
$195.44
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $177.86 | 1 |
| AL | $141.19 | 1 |
| AR | $138.92 | 1 |
| AZ | $154.49 | 1 |
| CA | $171.17–$219.71 | 29 |
| CO | $167.34 | 1 |
| CT | $170.27 | 1 |
| DC | $184.36 | 1 |
| DE | $157.25 | 1 |
| FL | $154.26–$168.07 | 3 |
| GA | $144.94–$161.67 | 2 |
| GU | $176.40 | 1 |
| HI | $176.40 | 1 |
| IA | $146.17 | 1 |
| ID | $147.01 | 1 |
| IL | $148.62–$164.58 | 4 |
| IN | $147.98 | 1 |
| KS | $144.94 | 1 |
| KY | $143.89 | 1 |
| LA | $143.45–$151.38 | 2 |
| MA | $165.99–$185.70 | 2 |
| MD | $160.63–$184.36 | 3 |
| ME | $147.36–$156.92 | 2 |
| MI | $147.61–$155.89 | 2 |
| MN | $161.24 | 1 |
| MO | $140.40–$152.55 | 3 |
| MS | $139.71 | 1 |
| MT | $158.98 | 1 |
| NC | $149.15 | 1 |
| ND | $157.60 | 1 |
| NE | $147.20 | 1 |
| NH | $164.20 | 1 |
| NJ | $172.46–$182.04 | 2 |
| NM | $148.31 | 1 |
| NV | $158.73 | 1 |
| NY | $151.58–$187.80 | 5 |
| OH | $147.33 | 1 |
| OK | $144.10 | 1 |
| OR | $157.76–$173.65 | 2 |
| PA | $147.85–$165.35 | 2 |
| PR | $160.43 | 1 |
| RI | $163.59 | 1 |
| SC | $148.43 | 1 |
| SD | $157.44 | 1 |
| TN | $145.69 | 1 |
| TX | $146.74–$166.55 | 8 |
| UT | $150.69 | 1 |
| VA | $156.02–$184.36 | 2 |
| VI | $160.43 | 1 |
| VT | $156.49 | 1 |
| WA | $165.84–$190.16 | 2 |
| WI | $151.73 | 1 |
| WV | $142.41 | 1 |
| WY | $158.38 | 1 |
How the 78466 rate is calculated
Each of 78466’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 · 78466
RVUs × geographic indexes × conversion factor
Work0.67
0.67 RVUs× 1.000 GPCI
Practice expense4.02
4.02 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
4.7600
Conversion factor
$33.4009
Medicare rate
$158.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78466
The CMS indicators that decide how 78466 is paid alongside other services.
CMS payment indicators · 78466
Infarct imaging
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| 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
78466 without 26 · national office
$158.99
Infarct imaging
78466-26 · Professional component
$31.40
Pays only the interpretation and report.
78466 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78468Cardiac infarct imaging
- This code is planar infarct-avid imaging without the additional ejection-fraction assessment described by 78468.
- 78469Infarct imaging
- Use 78466 for planar imaging and 78469 when the infarct-avid study is performed using SPECT.
- 78453Heart perfusion imaging
- Code 78453 describes planar myocardial perfusion imaging. Code 78466 is for imaging uptake of an infarct-avid radiopharmaceutical.
78466 billing questions
How does this differ from 78468?
Both are planar myocardial infarct-avid imaging, but 78468 includes ejection-fraction assessment. Use 78466 when the documented service does not include that additional assessment.
How does this differ from 78469?
Code 78466 describes planar infarct-avid imaging; 78469 is the SPECT form of infarct-avid imaging. Choose based on the imaging method documented.
Can the professional and technical services be billed separately?
Yes. Report modifier 26 for the interpretation and modifier TC for the technical service; without a modifier, the claim represents the global service.
Which portion is subject to the multiple-procedure reduction?
The cardiovascular diagnostic multiple-procedure reduction applies to the technical component. It does not change the professional component under the CMS rule supplied for this code.
Can this code be used for myocardial perfusion imaging?
No. This code is for planar infarct-avid imaging; myocardial perfusion studies, such as 78453, describe a different imaging purpose.
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
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