$170.58
78481 reports the primary single-study first-pass cardiac blood-pool service; 78496 is supplemental and cannot replace that primary code.
On this page
CMS RVU26D · Effective 2026-10-01
78496 Cardiac blood pool Medicare reimbursement rates in Colorado
Reports supplemental first-pass cardiac blood-pool imaging used with a primary study to assess ventricular function, wall motion, and ejection fraction. Compare 78496 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 78496 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
$44.00
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 cardiology
About 78496: First-pass cardiac blood-pool imaging add-on
Reports supplemental first-pass cardiac blood-pool imaging used with a primary study to assess ventricular function, wall motion, and ejection fraction.
This add-on represents supplemental imaging performed with a first-pass cardiac blood-pool study. The study follows a radiotracer bolus as it passes through the heart, allowing assessment of ventricular function, wall motion, and ejection fraction. Nuclear medicine physicians, radiologists, or cardiologists typically interpret the diagnostic images; nuclear medicine staff operate the imaging equipment in hospital or outpatient settings.
Report 78496 only with its eligible primary cardiac blood-pool procedure, such as a first-pass study, and document the additional imaging and its relationship to that study. CMS treats it as an add-on paid within the primary procedure's global period. The diagnostic service may be billed globally, or divided between the professional interpretation with modifier 26 and the technical service with modifier TC. Documentation should identify the first-pass study, the supplemental imaging performed, and the interpretation; do not report 78496 as a stand-alone service.
CMS billing rules for 78496
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- 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.
Where the value comes from
- Work RVU0.49 · 39%
- Practice expense (office) RVU0.75 · 59%
- Malpractice RVU0.03 · 2%
161
Medicare services in 2024 · #4507 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.
78496 compared with similar codes
Office rates for Colorado, from the same CMS release.
$230.25
78483 reports the primary multiple-study first-pass service. Use 78496 only when the supplemental imaging is performed with an eligible primary procedure.
$221.74
78494 is a gated-equilibrium cardiac blood-pool study. 78496 is an add-on associated with a primary study, rather than a stand-alone equilibrium study.
Compare 78496 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
$44.00
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 78496 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
9,419
- Code
- 78496
- Physician work
- 0.49
- Practice expense
- 0.75
- Malpractice
- 0.03
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.49 | × 1.012 | 0.4959 |
| Practice expense | 0.75 | × 1.064 | 0.7980 |
| Malpractice | 0.03 | × 0.781 | 0.0234 |
| Total RVUs | 1.3173 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$44.00
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.49 | 1.012 |
| Practice expense | 0.75 | 1.064 |
| Malpractice | 0.03 | 0.781 |
(0.49 × 1.012 + 0.75 × 1.064 + 0.03 × 0.781) × $33.4009 = $44.00
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.
78496 billing questions
Can 78496 be billed by itself?
No. It is an add-on and must be reported with an eligible primary cardiac blood-pool procedure, such as 78481 or 78483.
How does 78496 differ from 78481?
78481 reports the primary first-pass cardiac blood-pool study. 78496 reports supplemental imaging performed with an eligible primary study.
Which modifiers identify the professional and technical services?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
What documentation supports reporting 78496?
Document the primary first-pass study, the supplemental imaging performed, and the diagnostic interpretation. The record should support reporting the add-on with the primary procedure.
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.
9,41678494,,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
9,42078496,26,Heart first pass add-on,A,,0.49,0.18,,0.18,,0.02,0.69,0.69,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,42178496,TC,Heart first pass add-on,A,,0.00,0.57,,0.57,NA,0.01,0.58,0.58,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
9,42278499,,Unlisted cv px dx nuc med,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,,33.4009,09,0,99,0.00,0.00,0.00
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