$288.86–$304.39
Choose 78451 for one SPECT perfusion study. Choose 78452 for multiple distinct studies, such as rest and stress or studies involving redistribution or reinjection.
On this page
CMS RVU26D · Effective 2026-10-01
78452 Nuclear stress test Medicare reimbursement rates in Michigan
Myocardial perfusion SPECT with multiple distinct studies, typically rest and stress imaging, is reported for the complete multiple-study examination. Compare 78452 office and facility rates across CMS payment localities in Michigan.
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 78452 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$396.17–$417.87
2 of 2 localities have a supported rate.
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 78452: Myocardial perfusion SPECT, multiple studies
Myocardial perfusion SPECT with multiple distinct studies, typically rest and stress imaging, is reported for the complete multiple-study examination.
Myocardial perfusion SPECT uses a radiotracer, such as technetium-99m sestamibi or tetrofosmin, and a gamma camera to assess blood flow to the heart muscle. Separate studies are commonly acquired at rest and after exercise or pharmacologic stress; redistribution or reinjection imaging may also be performed. Comparing the studies helps distinguish reversible perfusion defects from fixed defects. Attenuation correction, wall motion, ejection fraction, and additional quantification are included when performed. Nuclear cardiology teams perform the scan in offices, imaging centers, and hospital departments; a cardiologist or nuclear medicine physician interprets it.
Report one unit for the complete multiple-study SPECT examination, even when its phases occur on different days. Document the distinct study phases, tracer, stress method, and imaging findings. A separately performed and documented cardiovascular stress test may be reported with 93015 or the appropriate 93016–93018 components; tracer and stress-agent billing depends on the setting. Use modifier 26 for interpretation only, TC for the equipment and staff portion, or no component modifier for the global service. CMS applies the cardiovascular diagnostic multiple procedure reduction to the technical component when applicable.
CMS billing rules for 78452
- 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 RVU1.58 · 12%
- Practice expense (office) RVU11.10 · 87%
- Malpractice RVU0.13 · 1%
1.2M
Medicare services in 2024 · #129 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.
78452 compared with similar codes
Office rates for Michigan, from the same CMS release.
$353.68–$373.64
Choose 78454 when multiple perfusion studies use planar imaging without tomographic reconstruction. Choose 78452 when SPECT tomographic imaging is used.
78492
No office rateMyocrd img pet mlt rst&strs
Choose 78492 for multiple-study PET perfusion imaging. Choose 78452 when the multiple perfusion studies use SPECT.
$248.60–$261.85
Choose 78473 for multiple-study gated cardiac blood pool imaging. Choose 78452 for multiple-study SPECT perfusion imaging; function data obtained as part of that perfusion study is included.
Compare 78452 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
$417.87
Facility
Unavailable
Rest Of Michigan →
Office / nonfacility
$396.17
Facility
Unavailable
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78452 billing questions
When should 78451 be used instead of 78452?
Use 78451 for one SPECT perfusion study, such as a stress-only protocol in which rest imaging is omitted. Use 78452 when multiple distinct perfusion studies are performed, such as rest and stress.
Is the treadmill or pharmacologic stress test included?
The separately performed and documented cardiovascular stress test may be reported with 93015, or with the appropriate components 93016, 93017, and 93018 when the work is split. Separate billing for the radiotracer or pharmacologic stress agent depends on the setting.
Can gated wall motion or ejection fraction be billed separately?
Wall motion, ejection fraction, attenuation correction, and additional quantification are included in 78452 when performed. Do not add a gated blood pool code solely to report function data obtained from the perfusion study.
How is a two-day protocol reported?
Report one unit of 78452 for the complete multiple-study examination when its phases occur on two days. Document the phases performed on each day.
Which modifiers apply in a hospital setting?
A physician billing only the interpretation uses 78452-26; the hospital bills its facility services separately. A practice furnishing both the technical service and interpretation bills the global code without a component modifier.
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.
9,36578451,,Ht muscle image spect sing,A,,1.35,7.87,,7.87,NA,0.10,9.32,9.32,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,39.82,39.82,0.32
9,36678451,26,Ht muscle image spect sing,A,,1.35,0.49,,0.49,,0.05,1.89,1.89,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,36778451,TC,Ht muscle image spect sing,A,,0.00,7.38,,7.38,NA,0.05,7.43,7.43,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,39.33,39.33,0.27
9,36878452,,Ht muscle image spect mult,A,,1.58,11.10,,11.10,NA,0.13,12.81,12.81,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,39.93,39.93,0.32
9,36978452,26,Ht muscle image spect mult,A,,1.58,0.59,,0.59,,0.06,2.23,2.23,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,37078452,TC,Ht muscle image spect mult,A,,0.00,10.51,,10.51,NA,0.07,10.58,10.58,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,39.34,39.34,0.26
9,37178453,,Ht muscle image planar sing,A,,0.98,6.79,,6.79,NA,0.10,7.87,7.87,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,39.62,39.62,0.36