Billing code 78466: Infarct imagingMedicare rate & RVUs in Nebraska

Planar myocardial infarct imaging depicts uptake of an infarct-avid radiopharmaceutical to evaluate suspected myocardial injury, rather than myocardial perfusion.

CMS RVU26DEffective Oct 1, 20261 payment locality126 Medicare services in 2024

Medicare pays $147.20 for 78466 in the office in Nebraska (Nebraska). Which amount applies depends on the service address.

$147.20Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 78466 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nebraska
  2. What 78466 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 78466 covers

This service is planar nuclear imaging that captures uptake of an infarct-avid radiopharmaceutical in the heart. It may be used to evaluate suspected myocardial injury; technetium-labeled pyrophosphate is a familiar example of an infarct-avid tracer. A nuclear medicine technologist performs the acquisition, and a nuclear medicine physician or other qualified physician interprets the images. The study is distinct from imaging designed to measure myocardial perfusion.

Report the code when the documented examination is planar infarct-avid imaging. The record should identify the imaging method and support the clinical question addressed; do not select it for a perfusion study or a tomographic infarct-avid study. Modifier 26 represents the physician’s interpretation, modifier TC represents the equipment and staff, and billing without either modifier represents 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.

78466 in Nebraska

78466 office and facility rates by payment locality
Payment localityOfficeFacility
Nebraska$147.20Unavailable

How the 78466 rate is calculated

Each of 78466’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 · 78466

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.67Practice expense 4.02Malpractice 0.07

4.7600 adjusted RVUs×$33.4009 conversion factor=$158.99

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 78466

The CMS indicators that decide how 78466 is paid alongside other services.

CMS payment indicators · 78466

Infarct imaging

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures6Diagnostic cardiovascular reduction applies to the technical component.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

78466 without 26 · national office

$158.99

Infarct imaging

78466-26 · Professional component

$31.40

Pays only the interpretation and report.

When to use modifier 26

78466 compared with similar codes

Compare codes

78466 vs 78468 vs 78469 vs 78453: national Medicare rates

Swap in your local Medicare rate.

  • 78466
    Infarct imaging · 0.67 wRVU
    $158.99
  • 78468
    Cardiac infarct imaging · 0.78 wRVU
    $183.04+$24.05
  • 78469
    Infarct imaging · 0.9 wRVU
    $203.75+$44.76
  • 78453
    Heart perfusion imaging · 0.98 wRVU
    $262.87+$103.88

How to choose

78468Cardiac infarct imaging
This code is planar infarct-avid imaging without the additional ejection-fraction assessment described by 78468.
78469Infarct imaging
Use 78466 for planar imaging and 78469 when the infarct-avid study is performed using SPECT.
78453Heart perfusion imaging
Code 78453 describes planar myocardial perfusion imaging. Code 78466 is for imaging uptake of an infarct-avid radiopharmaceutical.

78466 billing questions

How does this differ from 78468?

Both are planar myocardial infarct-avid imaging, but 78468 includes ejection-fraction assessment. Use 78466 when the documented service does not include that additional assessment.

How does this differ from 78469?

Code 78466 describes planar infarct-avid imaging; 78469 is the SPECT form of infarct-avid imaging. Choose based on the imaging method documented.

Can the professional and technical services be billed separately?

Yes. Report modifier 26 for the interpretation and modifier TC for the technical service; without a modifier, the claim represents the global service.

Which portion is subject to the multiple-procedure reduction?

The cardiovascular diagnostic multiple-procedure reduction applies to the technical component. It does not change the professional component under the CMS rule supplied for this code.

Can this code be used for myocardial perfusion imaging?

No. This code is for planar infarct-avid imaging; myocardial perfusion studies, such as 78453, describe a different imaging purpose.

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
RVUs for 78466PPRRVU2026_Oct_nonQPP.csv, line 9,389 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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