Billing code 78445: Vascular flow studyMedicare rate & RVUs in Michigan
Reports radionuclide imaging used to assess blood flow through a selected vascular territory when clinicians need a functional flow study.
Medicare pays $154.37–$163.41 for 78445 in the office in Michigan, from Rest Of Michigan to Detroit. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 78445 covers
This nuclear medicine study uses a radiotracer and imaging to assess blood movement through a selected vascular territory. It may be ordered when a clinician is evaluating suspected impaired circulation, including limb perfusion concerns. Nuclear medicine technologists acquire the study, and a qualified physician interprets the images. The service is generally performed in a hospital or other diagnostic imaging facility.
Report 78445 for the vascular flow imaging service, supported by documentation identifying the clinical indication, vascular territory examined, imaging performed, and physician interpretation. The code has professional and technical components: report modifier 26 for the interpretation, TC for the equipment and staff, or no modifier for the global service. When multiple cardiovascular diagnostic procedures are performed, the multiple procedure reduction applies to the technical component.
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.
Where 78445 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit | $163.41 | Unavailable |
| Rest Of Michigan | $154.37 | Unavailable |
How the 78445 rate is calculated
Each of 78445’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 78445
RVUs × geographic indexes × conversion factor
Work0.48
0.48 RVUs× 1.000 GPCI
Practice expense4.45
4.45 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
5.0000
Conversion factor
$33.4009
Medicare rate
$167.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 78445
The CMS indicators that decide how 78445 is paid alongside other services.
CMS payment indicators · 78445
Vascular flow study
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
78445 without 26 · national office
$167.00
Vascular flow study
78445-26 · Professional component
$22.71
Pays only the interpretation and report.
78445 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 78456Venous thrombosis imaging
- 78456 is directed to acute venous thrombosis imaging. Choose 78445 for a vascular flow study that is not specifically an acute thrombus examination.
- 78457Venous imaging
- 78457 describes venous thrombosis imaging focused on venous flow. 78445 is the broader vascular flow study selection.
- 78458Venous imaging
- 78458 is the bilateral venous thrombosis imaging option. 78445 is not distinguished by a bilateral venous thrombosis study.
78445 billing questions
When is 78445 preferable to venous thrombosis imaging?
Use 78445 for a vascular flow study. When the clinical question is specifically venous thrombosis, compare the dedicated thrombosis imaging options, such as 78456 or 78457.
How should the professional and technical portions be reported?
Use modifier 26 for the physician's interpretation and TC for the technical service. Reporting without either modifier represents the global service.
Does the multiple procedure reduction affect both components?
The cardiovascular diagnostic multiple procedure reduction applies to the technical component when multiple qualifying procedures are performed.
What documentation supports reporting 78445?
Document the reason for the study, the vascular territory imaged, the imaging performed, and the physician's interpretation of the flow findings.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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