$422.01
Both describe myocardial perfusion SPECT. Choose 78451 for one rest or stress study; 78452 represents multiple studies, commonly rest and stress.
On this page
CMS RVU26D · Effective 2026-10-01
78451 Cardiac SPECT Medicare reimbursement rates in Vermont
Reports one SPECT myocardial perfusion study at rest or stress to assess blood flow to the heart muscle in suspected or known coronary disease. Compare 78451 office and facility rates across CMS payment localities in Vermont.
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 78451 in Vermont?
Vermont 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
$307.02
1 of 1 localities have a supported rate.
Payment area: Vermont
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 78451: Single-study myocardial SPECT perfusion imaging
Reports one SPECT myocardial perfusion study at rest or stress to assess blood flow to the heart muscle in suspected or known coronary disease.
This service uses a radiopharmaceutical and a gamma camera to create tomographic images of myocardial perfusion for one study, performed at rest or under exercise or pharmacologic stress. Cardiologists, nuclear medicine physicians, and radiologists may interpret the images in hospital or outpatient imaging settings. Clinicians commonly use the study to evaluate suspected or established coronary artery disease and possible ischemia or prior myocardial injury.
Report 78451 for a single rest or stress study; when both rest and stress studies are performed, 78452 is the related SPECT code. Documentation should identify the study condition and support the imaging and interpretation performed. The code has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component.
CMS billing rules for 78451
- 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 RVU1.35 · 14%
- Practice expense (office) RVU7.87 · 84%
- Malpractice RVU0.10 · 1%
20.3K
Medicare services in 2024 · #1143 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.
78451 compared with similar codes
Office rates for Vermont, from the same CMS release.
$258.95
78453 describes a single myocardial perfusion study using planar imaging. 78451 is for tomographic SPECT imaging.
$376.46
78454 is the multiple-study planar myocardial perfusion code. 78451 is tomographic SPECT for a single study.
78491
No office rateMyocrd img pet 1std rst/strs
78491 is myocardial perfusion imaging with PET. Use 78451 when the modality performed is SPECT.
Compare 78451 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
Vermont →
Office / nonfacility
$307.02
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 78451 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
9,365
- Code
- 78451
- Physician work
- 1.35
- Practice expense
- 7.87
- Malpractice
- 0.10
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.35 | × 1.000 | 1.3500 |
| Practice expense | 7.87 | × 0.990 | 7.7913 |
| Malpractice | 0.10 | × 0.506 | 0.0506 |
| Total RVUs | 9.1919 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$307.02
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.35 | 1 |
| Practice expense | 7.87 | 0.99 |
| Malpractice | 0.1 | 0.506 |
(1.35 × 1 + 7.87 × 0.99 + 0.1 × 0.506) × $33.4009 = $307.02
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.
78451 billing questions
When is 78451 reported instead of 78452?
Use 78451 for one SPECT myocardial perfusion study at rest or stress. When the service includes both rest and stress studies, compare the documentation with 78452.
Does one study mean one image or one view?
No. The distinction is the number of myocardial perfusion studies, not the number of image slices or views. Document whether the single study was performed at rest or stress.
How should the professional and technical work be billed?
Use modifier 26 for the physician's interpretation and modifier TC for the equipment and staff. Report the global service without either component modifier when one claim includes both portions.
Can the technical component be reduced when other tests are performed?
The cardiovascular diagnostic multiple procedure reduction applies to the technical component of 78451. It does not change the professional component under the CMS rule provided.
What documentation supports 78451?
Document that myocardial perfusion SPECT was performed, whether the single study was at rest or stress, and the physician's interpretation. For stress imaging, identify the stress method used.
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.
9,36278445,,Vascular flow imaging,A,,0.48,4.45,,4.45,NA,0.07,5.00,5.00,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,12.28,12.28,0.14
9,36378445,26,Vascular flow imaging,A,,0.48,0.17,,0.17,,0.03,0.68,0.68,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,36478445,TC,Vascular flow imaging,A,,0.00,4.28,,4.28,NA,0.04,4.32,4.32,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,12.11,12.11,0.11
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817