$235.24–$298.16
Both use first-pass cardiac function imaging, but 78481 represents one study and 78483 represents multiple studies.
On this page
CMS RVU26D · Effective 2026-10-01
78481 Cardiac function imaging Medicare reimbursement rates in California
Reports one radionuclide first-pass cardiac function study, using sequential images to evaluate ventricular motion and ejection fraction. Compare 78481 office and facility rates across CMS payment localities in California.
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 78481 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$174.44–$221.92
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $47.48 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 78481 pays more and less in California
29 payment localities
$174.44 to $221.92
Nuclear cardiology
About 78481: Single first-pass cardiac function study
Reports one radionuclide first-pass cardiac function study, using sequential images to evaluate ventricular motion and ejection fraction.
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.
CMS billing rules for 78481
- 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 RVU0.96 · 20%
- Practice expense (office) RVU3.85 · 79%
- Malpractice RVU0.05 · 1%
639
Medicare services in 2024 · #3344 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.
78481 compared with similar codes
Office rates for California, from the same CMS release.
$223.30–$286.03
78481 tracks the tracer during its first passage through the heart; 78472 is a single gated blood-pool study.
$226.61–$288.81
78481 uses first-pass acquisition, while 78494 is cardiac SPECT imaging.
Compare 78481 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $174.63 | Facility Unavailable |
| Chico | Office $174.44 | Facility Unavailable |
| El Centro | Office $174.45 | Facility Unavailable |
| Fresno | Office $174.44 | Facility Unavailable |
| Hanford-Corcoran | Office $174.44 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $186.61 | Facility Unavailable |
| Madera | Office $174.44 | Facility Unavailable |
| Merced | Office $174.44 | Facility Unavailable |
| Modesto | Office $174.44 | Facility Unavailable |
| Napa | Office $204.42 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $186.00 | Facility Unavailable |
| Redding | Office $174.44 | Facility Unavailable |
| Rest Of California | Office $174.44 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $175.01 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $183.67 | Facility Unavailable |
| Salinas | Office $182.99 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $187.73 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $217.19 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $217.14 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $221.92 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $221.69 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $179.97 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $189.87 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $183.80 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $191.83 | Facility Unavailable |
| Stockton | Office $174.44 | Facility Unavailable |
| Vallejo | Office $204.34 | Facility Unavailable |
| Visalia | Office $174.44 | Facility Unavailable |
| Yuba City | Office $174.44 | Facility Unavailable |
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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 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.
9,40178473,,Gated heart multiple,A,,1.43,6.45,,6.45,NA,0.11,7.99,7.99,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,12.66,12.66,0.16
9,40278473,26,Gated heart multiple,A,,1.43,0.54,,0.54,,0.06,2.03,2.03,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,40378473,TC,Gated heart multiple,A,,0.00,5.91,,5.91,NA,0.05,5.96,5.96,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,12.12,12.12,0.10
9,40478481,,Heart first pass single,A,,0.96,3.85,,3.85,NA,0.05,4.86,4.86,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,16.82,16.82,0.16
9,40578481,26,Heart first pass single,A,,0.96,0.35,,0.35,,0.02,1.33,1.33,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,40678481,TC,Heart first pass single,A,,0.00,3.50,,3.50,NA,0.03,3.53,3.53,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,16.47,16.47,0.14
9,40778483,,Heart first pass multiple,A,,1.43,5.06,,5.06,NA,0.08,6.57,6.57,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,17.03,17.03,0.16