$229.95
Choose 78494 for gated equilibrium cardiac blood-pool SPECT. Choose 78472 when the corresponding single-study acquisition is planar.
On this page
CMS RVU26D · Effective 2026-10-01
78494 Cardiac blood-pool imaging Medicare reimbursement rates in Hawaii
Reports ECG-gated SPECT imaging of the cardiac blood pool to assess ventricular function and wall motion rather than myocardial perfusion. Compare 78494 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 78494 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
$233.03
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 78494: Gated cardiac blood-pool SPECT
Reports ECG-gated SPECT imaging of the cardiac blood pool to assess ventricular function and wall motion rather than myocardial perfusion.
This study uses a radiotracer in the circulating blood and ECG gating to create tomographic images of the heart across the cardiac cycle. It helps assess ventricular function and wall motion, including left ventricular function monitoring in patients receiving potentially cardiotoxic chemotherapy. Nuclear medicine physicians or other qualified imaging professionals typically perform and interpret the study in hospital or outpatient imaging settings. Unlike myocardial perfusion SPECT, it images the blood pool rather than tracer uptake in heart muscle.
Report 78494 when the documented acquisition is gated equilibrium cardiac blood-pool SPECT. The record should support the cardiac indication, the SPECT blood-pool technique, and the physician’s interpretation. The code has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component when the rule applies; it does not reduce the professional component under this rule.
CMS billing rules for 78494
- 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 RVU1.16 · 18%
- Practice expense (office) RVU5.07 · 80%
- Malpractice RVU0.09 · 1%
324
Medicare services in 2024 · #3937 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.
78494 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$179.24
78481 describes first-pass blood-pool imaging. 78494 is for gated equilibrium blood-pool SPECT.
$345.90
78451 evaluates myocardial perfusion with SPECT for a single study. 78494 images the cardiac blood pool to assess ventricular function and wall motion.
$476.83
78452 is multiple-study myocardial perfusion SPECT, not gated equilibrium blood-pool SPECT.
Compare 78494 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
$233.03
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 78494 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
9,416
- Code
- 78494
- Physician work
- 1.16
- Practice expense
- 5.07
- Malpractice
- 0.09
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.16 | × 1.000 | 1.1600 |
| Practice expense | 5.07 | × 1.137 | 5.7646 |
| Malpractice | 0.09 | × 0.579 | 0.0521 |
| Total RVUs | 6.9767 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$233.03
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.16 | 1 |
| Practice expense | 5.07 | 1.137 |
| Malpractice | 0.09 | 0.579 |
(1.16 × 1 + 5.07 × 1.137 + 0.09 × 0.579) × $33.4009 = $233.03
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.
78494 billing questions
How does 78494 differ from 78472?
78494 is for gated equilibrium SPECT blood-pool imaging. 78472 is the planar version for a single study.
Is this a myocardial perfusion study?
No. It images the cardiac blood pool to evaluate ventricular function and wall motion. Codes 78451 and 78452 describe myocardial perfusion SPECT.
When should modifier 26 or TC be used?
Use modifier 26 for the physician’s interpretation and modifier TC for the technical service. Report without either modifier when billing the global service.
Which part is subject to the multiple-procedure reduction?
CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component. The stated reduction rule does not apply to the professional component.
What documentation supports reporting 78494?
Document the indication, gated equilibrium blood-pool SPECT technique, and interpretation. The record should distinguish this acquisition from planar or first-pass imaging.
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.
9,41378492,,Myocrd img pet mlt rst&strs,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,,33.4009,09,0,99,44.38,44.38,0.07
9,41478492,26,Myocrd img pet mlt rst&strs,A,,1.76,0.65,,0.65,,0.06,2.47,2.47,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,41578492,TC,Myocrd img pet mlt rst&strs,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,,33.4009,01,0,99,43.73,43.73,0.01
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
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