$181.78–$286.03
Choose 78494 for gated equilibrium cardiac blood-pool SPECT. Choose 78472 when the corresponding single-study acquisition is planar.
On this page
CMS RVU26D · Effective 2026-10-01
78494 Cardiac blood-pool imaging Medicare reimbursement rates
Reports ECG-gated SPECT imaging of the cardiac blood pool to assess ventricular function and wall motion rather than myocardial perfusion. Compare 78494 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 78494?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$185.76–$288.81
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $103.05 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 78494 pays more and less
109 payment localities
$185.76 to $288.81
Nuclear cardiology
About 78494: Gated cardiac blood-pool SPECT
Reports ECG-gated SPECT imaging of the cardiac blood pool to assess ventricular function and wall motion rather than myocardial perfusion.
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.
CMS billing rules for 78494
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Cardiovascular diagnostic multiple procedure reduction applies to the technical component.
Where the value comes from
- Work RVU1.16 · 18%
- Practice expense (office) RVU5.07 · 80%
- Malpractice RVU0.09 · 1%
324
Medicare services in 2024 · #3937 by national volume
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.
78494 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$143.39–$221.92
78481 describes first-pass blood-pool imaging. 78494 is for gated equilibrium blood-pool SPECT.
$272.61–$430.89
78451 evaluates myocardial perfusion with SPECT for a single study. 78494 images the cardiac blood pool to assess ventricular function and wall motion.
$373.48–$595.53
78452 is multiple-study myocardial perfusion SPECT, not gated equilibrium blood-pool SPECT.
See how rates vary across the country
78494 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $240.12 | 1 |
| AL | $188.62 | 1 |
| AR | $185.76 | 1 |
| AZ | $205.41 | 1 |
| CA | $226.61–$288.81 | 29 |
| CO | $221.74 | 1 |
| CT | $225.54 | 1 |
| DC | $243.67 | 1 |
| DE | $208.95 | 1 |
| FL | $205.15–$222.63 | 3 |
| GA | $193.38–$214.52 | 2 |
| GU | $233.03 | 1 |
| HI | $233.03 | 1 |
| IA | $194.89 | 1 |
| ID | $195.96 | 1 |
| IL | $198.05–$218.26 | 4 |
| IN | $197.19 | 1 |
| KS | $193.35 | 1 |
| KY | $192.04 | 1 |
| LA | $191.49–$201.51 | 2 |
| MA | $220.08–$245.20 | 2 |
| MD | $213.27–$243.67 | 3 |
| ME | $196.41–$208.46 | 2 |
| MI | $196.75–$207.23 | 2 |
| MN | $213.89 | 1 |
| MO | $187.65–$202.97 | 3 |
| MS | $186.77 | 1 |
| MT | $211.09 | 1 |
| NC | $198.66 | 1 |
| ND | $209.31 | 1 |
| NE | $196.18 | 1 |
| NH | $217.66 | 1 |
| NJ | $228.51–$240.83 | 2 |
| NM | $197.64 | 1 |
| NV | $210.76 | 1 |
| NY | $201.73–$248.16 | 5 |
| OH | $196.38 | 1 |
| OK | $192.30 | 1 |
| OR | $209.52–$229.74 | 2 |
| PA | $197.04–$219.31 | 2 |
| PR | $212.91 | 1 |
| RI | $217.09 | 1 |
| SC | $197.77 | 1 |
| SD | $209.10 | 1 |
| TN | $194.29 | 1 |
| TX | $195.64–$220.65 | 8 |
| UT | $200.63 | 1 |
| VA | $207.33–$243.67 | 2 |
| VI | $212.91 | 1 |
| VT | $207.92 | 1 |
| WA | $219.85–$250.92 | 2 |
| WI | $201.90 | 1 |
| WV | $190.21 | 1 |
| WY | $210.31 | 1 |
Compare 78494 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $188.62 | Facility Unavailable |
| Alaska* | Office $240.12 | Facility Unavailable |
| Arizona | Office $205.41 | Facility Unavailable |
| Arkansas | Office $185.76 | Facility Unavailable |
| Atlanta | Office $214.52 | Facility Unavailable |
| Austin | Office $220.65 | Facility Unavailable |
| Bakersfield | Office $226.91 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $224.79 | Facility Unavailable |
| Beaumont | Office $195.64 | Facility Unavailable |
| Brazoria | Office $209.22 | Facility Unavailable |
| Chicago | Office $216.10 | Facility Unavailable |
| Chico | Office $226.61 | Facility Unavailable |
| Colorado | Office $221.74 | Facility Unavailable |
| Connecticut | Office $225.54 | Facility Unavailable |
| Dallas | Office $210.34 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $243.67 | Facility Unavailable |
| Delaware | Office $208.95 | Facility Unavailable |
| Detroit | Office $207.23 | Facility Unavailable |
| East St. Louis | Office $200.59 | Facility Unavailable |
| El Centro | Office $226.63 | Facility Unavailable |
| Fort Lauderdale | Office $215.72 | Facility Unavailable |
| Fort Worth | Office $208.68 | Facility Unavailable |
| Fresno | Office $226.61 | Facility Unavailable |
| Galveston | Office $209.70 | Facility Unavailable |
| Hanford-Corcoran | Office $226.61 | Facility Unavailable |
| Hawaii, Guam | Office $233.03 | Facility Unavailable |
| Houston | Office $211.35 | Facility Unavailable |
| Idaho | Office $195.96 | Facility Unavailable |
| Indiana | Office $197.19 | Facility Unavailable |
| Iowa | Office $194.89 | Facility Unavailable |
| Kansas | Office $193.35 | Facility Unavailable |
| Kentucky | Office $192.04 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $242.66 | Facility Unavailable |
| Madera | Office $226.61 | Facility Unavailable |
| Manhattan | Office $242.77 | Facility Unavailable |
| Merced | Office $226.61 | Facility Unavailable |
| Metropolitan Boston | Office $245.20 | Facility Unavailable |
| Metropolitan Kansas City | Office $200.69 | Facility Unavailable |
| Metropolitan Philadelphia | Office $219.31 | Facility Unavailable |
| Metropolitan St. Louis | Office $202.97 | Facility Unavailable |
| Miami | Office $222.63 | Facility Unavailable |
| Minnesota | Office $213.89 | Facility Unavailable |
| Mississippi | Office $186.77 | Facility Unavailable |
| Modesto | Office $226.61 | Facility Unavailable |
| Montana** | Office $211.09 | Facility Unavailable |
| Napa | Office $265.91 | Facility Unavailable |
| Nebraska | Office $196.18 | Facility Unavailable |
| Nevada** | Office $210.76 | Facility Unavailable |
| New Hampshire | Office $217.66 | Facility Unavailable |
| New Mexico | Office $197.64 | Facility Unavailable |
| New Orleans | Office $201.51 | Facility Unavailable |
| North Carolina | Office $198.66 | Facility Unavailable |
| North Dakota** | Office $209.31 | Facility Unavailable |
| Northern Nj | Office $240.83 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $248.16 | Facility Unavailable |
| Ohio | Office $196.38 | Facility Unavailable |
| Oklahoma | Office $192.30 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $241.87 | Facility Unavailable |
| Portland | Office $229.74 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $229.56 | Facility Unavailable |
| Puerto Rico | Office $212.91 | Facility Unavailable |
| Queens | Office $245.72 | Facility Unavailable |
| Redding | Office $226.61 | Facility Unavailable |
| Rest Of California | Office $226.61 | Facility Unavailable |
| Rest Of Florida | Office $205.15 | Facility Unavailable |
| Rest Of Georgia | Office $193.38 | Facility Unavailable |
| Rest Of Illinois | Office $198.05 | Facility Unavailable |
| Rest Of Louisiana | Office $191.49 | Facility Unavailable |
| Rest Of Maine | Office $196.41 | Facility Unavailable |
| Rest Of Maryland | Office $213.27 | Facility Unavailable |
| Rest Of Massachusetts | Office $220.08 | Facility Unavailable |
| Rest Of Michigan | Office $196.75 | Facility Unavailable |
| Rest Of Missouri | Office $187.65 | Facility Unavailable |
| Rest Of New Jersey | Office $228.51 | Facility Unavailable |
| Rest Of New York | Office $201.73 | Facility Unavailable |
| Rest Of Oregon | Office $209.52 | Facility Unavailable |
| Rest Of Pennsylvania | Office $197.04 | Facility Unavailable |
| Rest Of Texas | Office $202.17 | Facility Unavailable |
| Rest Of Washington | Office $219.85 | Facility Unavailable |
| Rhode Island | Office $217.09 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $227.61 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $238.70 | Facility Unavailable |
| Salinas | Office $237.83 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $244.07 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $282.58 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $282.48 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $288.81 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $288.39 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $233.90 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $246.92 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $238.89 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $249.47 | Facility Unavailable |
| Seattle (King Cnty) | Office $250.92 | Facility Unavailable |
| South Carolina | Office $197.77 | Facility Unavailable |
| South Dakota** | Office $209.10 | Facility Unavailable |
| Southern Maine | Office $208.46 | Facility Unavailable |
| Stockton | Office $226.61 | Facility Unavailable |
| Suburban Chicago | Office $218.26 | Facility Unavailable |
| Tennessee | Office $194.29 | Facility Unavailable |
| Utah | Office $200.63 | Facility Unavailable |
| Vallejo | Office $265.76 | Facility Unavailable |
| Vermont | Office $207.92 | Facility Unavailable |
| Virgin Islands | Office $212.91 | Facility Unavailable |
| Virginia | Office $207.33 | Facility Unavailable |
| Visalia | Office $226.61 | Facility Unavailable |
| West Virginia | Office $190.21 | Facility Unavailable |
| Wisconsin | Office $201.90 | Facility Unavailable |
| Wyoming** | Office $210.31 | Facility Unavailable |
| Yuba City | Office $226.61 | Facility Unavailable |
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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 stated reduction rule 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
9,41378492,,Myocrd img pet mlt rst&strs,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,44.38,44.38,0.07
9,41478492,26,Myocrd img pet mlt rst&strs,A,,1.76,0.65,,0.65,,0.06,2.47,2.47,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,41578492,TC,Myocrd img pet mlt rst&strs,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,43.73,43.73,0.01
9,41678494,,Heart image spect,A,,1.16,5.07,,5.07,NA,0.09,6.32,6.32,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,12.54,12.54,0.16
9,41778494,26,Heart image spect,A,,1.16,0.42,,0.42,,0.05,1.63,1.63,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,41878494,TC,Heart image spect,A,,0.00,4.65,,4.65,NA,0.04,4.69,4.69,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,12.12,12.12,0.11
9,41978496,,Heart first pass add-on,A,,0.49,0.75,,0.75,NA,0.03,1.27,1.27,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00