$280.43
Both describe planar gated-equilibrium blood-pool imaging; 78472 is for one study, while 78473 is for multiple studies.
On this page
CMS RVU26D · Effective 2026-10-01
78472 Cardiac blood-pool imaging Medicare reimbursement rates in Colorado
Reports a single planar gated blood-pool study used to assess ventricular function, including ejection fraction, with equilibrium radionuclide imaging. Compare 78472 office and facility rates across CMS payment localities in Colorado.
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 78472 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$218.27
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Nuclear medicine
About 78472: Planar gated cardiac blood-pool study
Reports a single planar gated blood-pool study used to assess ventricular function, including ejection fraction, with equilibrium radionuclide imaging.
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.
CMS billing rules for 78472
- 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 · 15%
- Practice expense (office) RVU5.17 · 83%
- Malpractice RVU0.08 · 1%
8.4K
Medicare services in 2024 · #1566 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.
78472 compared with similar codes
Office rates for Colorado, from the same CMS release.
$170.58
78481 reports single-study first-pass blood-pool imaging. 78472 uses the gated-equilibrium acquisition method.
$277.04
78453 is a single-study planar myocardial perfusion examination. 78472 images the cardiac blood pool to assess ventricular function.
$221.74
78494 uses SPECT for gated-equilibrium blood-pool imaging; 78472 is the planar study.
Compare 78472 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
$218.27
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 78472 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
9,398
- Code
- 78472
- Physician work
- 0.96
- Practice expense
- 5.17
- Malpractice
- 0.08
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.96 | × 1.012 | 0.9715 |
| Practice expense | 5.17 | × 1.064 | 5.5009 |
| Malpractice | 0.08 | × 0.781 | 0.0625 |
| Total RVUs | 6.5349 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$218.27
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.96 | 1.012 |
| Practice expense | 5.17 | 1.064 |
| Malpractice | 0.08 | 0.781 |
(0.96 × 1.012 + 5.17 × 1.064 + 0.08 × 0.781) × $33.4009 = $218.27
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
9,39578469,,Heart infarct image (3d),A,,0.90,5.12,,5.12,NA,0.08,6.10,6.10,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,16.80,16.80,0.18
9,39678469,26,Heart infarct image (3d),A,,0.90,0.33,,0.33,,0.04,1.27,1.27,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,39778469,TC,Heart infarct image (3d),A,,0.00,4.79,,4.79,NA,0.04,4.83,4.83,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,16.47,16.47,0.14
9,39878472,,Gated heart planar single,A,,0.96,5.17,,5.17,NA,0.08,6.21,6.21,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,12.47,12.47,0.14
9,39978472,26,Gated heart planar single,A,,0.96,0.34,,0.34,,0.04,1.34,1.34,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,40078472,TC,Gated heart planar single,A,,0.00,4.83,,4.83,NA,0.04,4.87,4.87,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,12.13,12.13,0.10
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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899