$144.94
Both codes concern myocardial infarct imaging. Choose 78469 for tomographic SPECT images and 78466 for planar imaging.
On this page
CMS RVU26D · Effective 2026-10-01
78469 Infarct imaging Medicare reimbursement rates in Kansas
Tomographic myocardial infarct imaging uses SPECT to localize infarct-related tracer uptake when a clinician needs a nuclear medicine assessment of myocardial injury. Compare 78469 office and facility rates across CMS payment localities in Kansas.
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 78469 in Kansas?
Kansas 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
$186.00
1 of 1 localities have a supported rate.
Payment area: Kansas
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 78469: Tomographic myocardial infarct imaging
Tomographic myocardial infarct imaging uses SPECT to localize infarct-related tracer uptake when a clinician needs a nuclear medicine assessment of myocardial injury.
This study uses a radiotracer and tomographic single-photon emission computed tomography (SPECT) images to show the distribution and location of uptake associated with myocardial infarction. It is performed in a nuclear medicine department or imaging center, commonly with interpretation by a nuclear medicine physician, cardiologist, or radiologist. The clinical question is infarct-related uptake, rather than stress-induced ischemia or routine myocardial perfusion assessment.
Select this code when the documented study is tomographic infarct imaging; planar infarct imaging is represented by related codes 78466 and 78468. The report should support the imaging method and interpretation, with the order or clinical record establishing the reason for the study. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component when applicable.
CMS billing rules for 78469
- 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 RVU0.90 · 15%
- Practice expense (office) RVU5.12 · 84%
- Malpractice RVU0.08 · 1%
810
Medicare services in 2024 · #3135 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.
78469 compared with similar codes
Office rates for Kansas, from the same CMS release.
$167.03
Code 78468 is the planar infarct imaging option associated with ejection fraction assessment; 78469 is the tomographic SPECT option.
$284.40
Code 78451 reports a single-study myocardial perfusion SPECT examination. It evaluates myocardial perfusion rather than infarct-related tracer uptake.
$390.12
Code 78452 is for multiple-study myocardial perfusion SPECT, commonly rest and stress imaging; 78469 is for tomographic infarct imaging.
Compare 78469 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
Kansas →
Office / nonfacility
$186.00
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 78469 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
9,395
- Code
- 78469
- Physician work
- 0.90
- Practice expense
- 5.12
- Malpractice
- 0.08
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.90 | × 1.000 | 0.9000 |
| Practice expense | 5.12 | × 0.904 | 4.6285 |
| Malpractice | 0.08 | × 0.504 | 0.0403 |
| Total RVUs | 5.5688 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$186.00
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.9 | 1 |
| Practice expense | 5.12 | 0.904 |
| Malpractice | 0.08 | 0.504 |
(0.9 × 1 + 5.12 × 0.904 + 0.08 × 0.504) × $33.4009 = $186.00
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.
78469 billing questions
How does this differ from code 78466?
Code 78469 represents tomographic SPECT infarct imaging. Code 78466 is for the planar form of infarct imaging.
How does this differ from code 78468?
Code 78468 is the planar infarct imaging option associated with ejection fraction assessment. Use 78469 for the tomographic SPECT infarct study.
When should modifier 26 or TC be reported?
Use modifier 26 for the physician’s interpretation and report, or TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
Does the multiple procedure reduction affect the interpretation?
The CMS cardiovascular diagnostic multiple procedure reduction applies to the technical component. It does not describe a reduction to the professional component.
Can this code be used for a myocardial perfusion SPECT study?
No. Code 78469 describes infarct imaging; myocardial perfusion SPECT studies are represented by codes such as 78451 or 78452, depending on the study performed.
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.
9,39278468,,Heart infarct image (ef),A,,0.78,4.63,,4.63,NA,0.07,5.48,5.48,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,16.75,16.75,0.18
9,39378468,26,Heart infarct image (ef),A,,0.78,0.29,,0.29,,0.03,1.10,1.10,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,39478468,TC,Heart infarct image (ef),A,,0.00,4.34,,4.34,NA,0.04,4.38,4.38,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,16.46,16.46,0.15
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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958