$258.03–$305.38
Both use planar myocardial imaging; 78453 is for a single study, while 78454 is for multiple studies.
On this page
CMS RVU26D · Effective 2026-10-01
78454 Heart imaging Medicare reimbursement rates in Virginia
Reports planar nuclear imaging of myocardial perfusion across multiple studies, commonly rest and stress acquisitions, when planar rather than tomographic imaging is performed. Compare 78454 office and facility rates across CMS payment localities in Virginia.
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 78454 in Virginia?
Virginia 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
$375.06–$444.39
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 78454: Planar myocardial imaging, multiple studies
Reports planar nuclear imaging of myocardial perfusion across multiple studies, commonly rest and stress acquisitions, when planar rather than tomographic imaging is performed.
This service uses a nuclear medicine camera to produce planar images of myocardial perfusion in more than one study. A common clinical use is comparison of rest and stress images when evaluating suspected or known coronary artery disease. Nuclear medicine physicians, radiologists, and cardiology imaging teams may perform or interpret the examination in hospital or outpatient imaging settings. The defining feature is planar acquisition; SPECT myocardial imaging is coded in a different code family.
Select this code when the record supports multiple planar myocardial imaging studies, rather than a single study or tomographic imaging. Documentation should identify the imaging approach and the studies performed, with an interpretation addressing the myocardial images. The code has professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither for the global service. CMS’s cardiovascular diagnostic multiple-procedure reduction applies to the technical component; the professional component is not subject to that reduction.
CMS billing rules for 78454
- 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 RVU1.31 · 11%
- Practice expense (office) RVU9.99 · 87%
- Malpractice RVU0.14 · 1%
4.7K
Medicare services in 2024 · #1919 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.
78454 compared with similar codes
Office rates for Virginia, from the same CMS release.
$420.29–$497.20
Both describe multiple-study myocardial imaging, but 78452 is for SPECT acquisition and 78454 is for planar acquisition.
$305.85–$360.90
78451 is single-study SPECT myocardial imaging. Choose 78454 for multiple planar studies.
Compare 78454 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
Dc + Md/Va Suburbs →
Office / nonfacility
$444.39
Facility
Unavailable
Virginia →
Office / nonfacility
$375.06
Facility
Unavailable
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78454 billing questions
How does this differ from 78453?
Both describe planar myocardial imaging. Use 78454 for multiple studies and 78453 for a single study.
When is 78452 a better fit?
78452 describes multiple-study myocardial imaging performed with SPECT. Choose 78454 when the acquisition is planar rather than tomographic.
Does multiple studies mean multiple planar views?
No. The distinction is the number of imaging studies, not simply the number of views or projections in one study.
How should the professional and technical portions be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Bill without either modifier when billing the global service.
What does the cardiovascular diagnostic multiple-procedure reduction affect?
CMS applies the reduction to the technical component. It does not apply to the professional component.
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.
9,37178453,,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
9,37278453,26,Ht muscle image planar sing,A,,0.98,0.33,,0.33,,0.05,1.36,1.36,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,37378453,TC,Ht muscle image planar sing,A,,0.00,6.46,,6.46,NA,0.05,6.51,6.51,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,39.29,39.29,0.31
9,37478454,,Ht musc image planar mult,A,,1.31,9.99,,9.99,NA,0.14,11.44,11.44,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,39.76,39.76,0.36
9,37578454,26,Ht musc image planar mult,A,,1.31,0.45,,0.45,,0.07,1.83,1.83,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,37678454,TC,Ht musc image planar mult,A,,0.00,9.54,,9.54,NA,0.07,9.61,9.61,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,39.31,39.31,0.29
9,37778456,,Acute venous thrombus image,A,,0.98,7.45,,7.45,NA,0.08,8.51,8.51,1,XXX,0.00,0.00,0.00,6,9,9,9,9,9,,33.4009,09,0,99,39.68,39.68,0.31