Billing code 78472: Cardiac blood-pool imagingMedicare rate & RVUs in Alabama
Reports a single planar gated blood-pool study used to assess ventricular function, including ejection fraction, with equilibrium radionuclide imaging.
Medicare pays $184.67 for 78472 in the office in Alabama (Alabama). Which amount applies depends on the service address.
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 9 sections
What 78472 covers
This nuclear medicine study tracks radiolabeled blood through the heart to assess ventricular function, commonly including ejection fraction and wall motion. A nuclear medicine technologist performs the acquisition, and a qualified physician interprets it. It is used in settings such as cardiac evaluation and monitoring ventricular function before or during potentially cardiotoxic chemotherapy.
Report this code for one planar gated-equilibrium study; use the multiple-study sibling when the service includes multiple studies. The record should support the acquisition method and study count, along with the clinical reason and interpretation. The code has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. The cardiovascular diagnostic 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.
78472 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $184.67 | Unavailable |
How the 78472 rate is calculated
Each of 78472’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 · 78472
RVUs × geographic indexes × conversion factor
Work0.96
0.96 RVUs× 1.000 GPCI
Practice expense5.17
5.17 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
6.2100
Conversion factor
$33.4009
Medicare rate
$207.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78472
The CMS indicators that decide how 78472 is paid alongside other services.
CMS payment indicators · 78472
Cardiac blood-pool 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
78472 without 26 · national office
$207.42
Cardiac blood-pool imaging
78472-26 · Professional component
$44.76
Pays only the interpretation and report.
78472 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 78473Gated heart imaging
- Both describe planar gated-equilibrium blood-pool imaging; 78472 is for one study, while 78473 is for multiple studies.
- 78481Cardiac function imaging
- 78481 reports single-study first-pass blood-pool imaging. 78472 uses the gated-equilibrium acquisition method.
- 78453Heart perfusion imaging
- 78453 is a single-study planar myocardial perfusion examination. 78472 images the cardiac blood pool to assess ventricular function.
- 78494Cardiac blood-pool imaging
- 78494 uses SPECT for gated-equilibrium blood-pool imaging; 78472 is the planar study.
78472 billing questions
When is 78472 selected instead of 78473?
Use 78472 for one planar gated-equilibrium study. Use 78473 when multiple studies are performed.
How does 78472 differ from first-pass imaging?
78472 describes gated-equilibrium blood-pool imaging. First-pass cardiac blood-pool imaging is reported with 78481 for a single study or 78483 for multiple studies.
Can the interpretation and technical service be billed separately?
Yes. Report modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
Which part is subject to the cardiovascular diagnostic multiple procedure reduction?
The reduction applies to the technical component of 78472. It does not apply to the professional component under the stated CMS rule.
What documentation supports reporting one study?
Document the planar gated-equilibrium acquisition, the number of studies performed, the clinical indication, and the physician's interpretation.
Is 78472 a myocardial perfusion study?
No. It evaluates cardiac blood-pool movement and ventricular function; myocardial perfusion codes describe imaging of blood flow to the heart muscle.
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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