CPT code 78469: Infarct imaging2026 Medicare rate & RVUs

Medicare pays $203.75 for 78469 nationally in the office. Local office rates run $178.34–$281.40.

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

What 78469 covers

This study uses a radiotracer and tomographic single-photon emission computed tomography (SPECT) images to show the distribution and location of uptake associated with myocardial infarction. It is performed in a nuclear medicine department or imaging center, commonly with interpretation by a nuclear medicine physician, cardiologist, or radiologist. The clinical question is infarct-related uptake, rather than stress-induced ischemia or routine myocardial perfusion assessment.

Select this code when the documented study is tomographic infarct imaging; planar infarct imaging is represented by related codes 78466 and 78468. The report should support the imaging method and interpretation, with the order or clinical record establishing the reason for the study. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component when applicable.

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 78469 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

78469 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 78469 rate is calculated

Each of 78469’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 78469

The CMS indicators that decide how 78469 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

78469 compared with similar codes

How to choose

78466Infarct imaging

Both codes concern myocardial infarct imaging. Choose 78469 for tomographic SPECT images and 78466 for planar imaging.

78468Cardiac infarct imaging

Code 78468 is the planar infarct imaging option associated with ejection fraction assessment; 78469 is the tomographic SPECT option.

78451Cardiac SPECT

Code 78451 reports a single-study myocardial perfusion SPECT examination. It evaluates myocardial perfusion rather than infarct-related tracer uptake.

78452Nuclear stress test

Code 78452 is for multiple-study myocardial perfusion SPECT, commonly rest and stress imaging; 78469 is for tomographic infarct imaging.

Codes related to 78469

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