$241.47
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 Hawaii
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 Hawaii.
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 Hawaii?
Hawaii 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
$179.24
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 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 Hawaii, from the same CMS release.
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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$179.24
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 78481 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
9,404
- Code
- 78481
- Physician work
- 0.96
- Practice expense
- 3.85
- Malpractice
- 0.05
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.96 | × 1.000 | 0.9600 |
| Practice expense | 3.85 | × 1.137 | 4.3775 |
| Malpractice | 0.05 | × 0.579 | 0.0290 |
| Total RVUs | 5.3664 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$179.24
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.96 | 1 |
| Practice expense | 3.85 | 1.137 |
| Malpractice | 0.05 | 0.579 |
(0.96 × 1 + 3.85 × 1.137 + 0.05 × 0.579) × $33.4009 = $179.24
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.
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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014