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Billing code 78481: Cardiac function imagingMedicare rate & RVUs

Reports one radionuclide first-pass cardiac function study, using sequential images to evaluate ventricular motion and ejection fraction.

CMS RVU26DEffective Oct 1, 2026109 payment localities639 Medicare services in 2024

Medicare pays $162.33 for 78481 nationally in the office. Local office rates run $143.39–$221.92.

Medicare rate · 78481

Cardiac function imaging

Swap in your local Medicare rate.

Work RVUs
0.96
Total RVUs
4.86
Global days
XXX

National rate · 2026

$162.33

Office setting, before claim adjustments.

See every locality for 78481 → · 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
  1. Medicare rate
  2. What 78481 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 78481 covers

A radiopharmaceutical bolus is followed as it moves through the heart, with rapid image acquisition during its first passage through the cardiac chambers. The resulting study supports quantitative assessment of cardiac function, including wall motion and ejection fraction. Nuclear medicine physicians, radiologists, or cardiologists may perform and interpret the examination in an imaging department or hospital setting, with or without pharmacologic intervention.

Report 78481 for a single first-pass study, rather than a series of first-pass studies. Documentation should identify the study performed and include the image interpretation and quantitative findings. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. When multiple cardiovascular diagnostic procedures are performed, CMS applies the multiple-procedure reduction 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 78481 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

$143.39 to $221.92

$143.39$182.65$221.92
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

78481 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$145.53Unavailable
Alaska*$185.97Unavailable
Arizona$158.10Unavailable
Arkansas$143.39Unavailable
Atlanta$164.82Unavailable
Austin$169.66Unavailable
Bakersfield$174.63Unavailable
Baltimore/Surr. Cntys$172.62Unavailable
Beaumont$150.64Unavailable
Brazoria$161.06Unavailable

78481 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.

$143.39

$198.18

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

View every state and territory as a table
78481 office rate range by state
State / territoryOffice rate rangeLocalities
AK$185.971
AL$145.531
AR$143.391
AZ$158.101
CA$174.44–$221.9229
CO$170.581
CT$173.221
DC$187.141
DE$160.781
FL$157.51–$170.153
GA$148.76–$164.822
GU$179.241
HI$179.241
IA$150.391
ID$151.161
IL$152.08–$167.314
IN$152.081
KS$149.161
KY$147.911
LA$147.47–$154.972
MA$169.32–$188.412
MD$164.06–$187.143
ME$151.41–$160.552
MI$151.36–$158.972
MN$164.881
MO$144.54–$156.163
MS$144.021
MT$162.331
NC$153.111
ND$161.341
NE$151.391
NH$167.391
NJ$175.60–$185.042
NM$151.991
NV$162.181
NY$155.40–$190.125
OH$151.151
OK$148.201
OR$161.32–$176.692
PA$151.69–$168.502
PR$163.721
RI$167.001
SC$152.301
SD$161.221
TN$149.851
TX$150.64–$169.668
UT$154.441
VA$159.65–$187.142
VI$163.721
VT$160.221
WA$169.16–$192.822
WI$155.771
WV$146.201
WY$161.891

How the 78481 rate is calculated

Each of 78481’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 · 78481

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.96Practice expense 3.85Malpractice 0.05

4.8600 adjusted RVUs×$33.4009 conversion factor=$162.33

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 78481

The CMS indicators that decide how 78481 is paid alongside other services.

CMS payment indicators · 78481

Cardiac function imaging

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

78481 without 26 · national office

$162.33

Cardiac function imaging

78481-26 · Professional component

$44.42

Pays only the interpretation and report.

When to use modifier 26

78481 compared with similar codes

Compare codes

78481 vs 78483 vs 78472 vs 78494: national Medicare rates

Swap in your local Medicare rate.

  • 78481
    Cardiac function imaging · 0.96 wRVU
    $162.33
  • 78483
    First-pass cardiac imaging · 1.43 wRVU
    $219.44+$57.11
  • 78472
    Cardiac blood-pool imaging · 0.96 wRVU
    $207.42+$45.09
  • 78494
    Cardiac blood-pool imaging · 1.16 wRVU
    $211.09+$48.76

How to choose

78483First-pass cardiac imaging
Both use first-pass cardiac function imaging, but 78481 represents one study and 78483 represents multiple studies.
78472Cardiac blood-pool imaging
78481 tracks the tracer during its first passage through the heart; 78472 is a single gated blood-pool study.
78494Cardiac blood-pool imaging
78481 uses first-pass acquisition, while 78494 is cardiac SPECT imaging.

Codes related to 78481

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

Codes related to 78481
CodeHow it relatesNational office range
Same family
78483First-pass cardiac imagingFirst-pass cardiac function imaging for multiple studies rather than one.$194.32–$298.16
Used instead
78472Cardiac blood-pool imagingSingle-study gated blood-pool imaging uses an equilibrium acquisition approach.$181.78–$286.03
78473Gated heart imagingMultiple-study gated blood-pool imaging differs from first-pass acquisition.$234.71–$365.64
78494Cardiac blood-pool imagingSPECT heart imaging uses tomographic acquisition rather than first-pass imaging.$185.76–$288.81

78481 billing questions

When is 78481 used instead of 78483?

Use 78481 for a single first-pass cardiac function study. Use 78483 when multiple first-pass studies are performed.

Can the interpretation and imaging be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

What happens when other cardiovascular diagnostic procedures are performed?

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

How does 78481 differ from a gated blood-pool study?

78481 follows the tracer during its first passage through the heart. Gated blood-pool imaging, such as 78472, uses a different acquisition approach.

What should the report document?

Document that a single first-pass study was performed, the interpretation, and quantitative findings such as wall motion and ejection fraction.

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 78481PPRRVU2026_Oct_nonQPP.csv, line 9,404 (RVU26D)

Open CMS sourceHow we calculate rates

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