Billing code 78481: Cardiac function imagingMedicare rate & RVUs in Virginia
Reports one radionuclide first-pass cardiac function study, using sequential images to evaluate ventricular motion and ejection fraction.
Medicare pays $159.65–$187.14 for 78481 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 78481 covers
A radiopharmaceutical bolus is followed as it moves through the heart, with rapid image acquisition during its first passage through the cardiac chambers. The resulting study supports quantitative assessment of cardiac function, including wall motion and ejection fraction. Nuclear medicine physicians, radiologists, or cardiologists may perform and interpret the examination in an imaging department or hospital setting, with or without pharmacologic intervention.
Report 78481 for a single first-pass study, rather than a series of first-pass studies. Documentation should identify the study performed and include the image interpretation and quantitative findings. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and no component modifier represents the global service. When multiple cardiovascular diagnostic procedures are performed, CMS applies the multiple-procedure reduction 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 78481 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $187.14 | Unavailable |
| Virginia | $159.65 | Unavailable |
How the 78481 rate is calculated
Each of 78481’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 · 78481
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.96Practice expense 3.85Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 78481
The CMS indicators that decide how 78481 is paid alongside other services.
CMS payment indicators · 78481
Cardiac function imaging
| 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
78481 without 26 · national office
$162.33
Cardiac function imaging
78481-26 · Professional component
$44.42
Pays only the interpretation and report.
78481 compared with similar codes
Compare codes
78481 vs 78483 vs 78472 vs 78494: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 78483First-pass cardiac imaging
- Both use first-pass cardiac function imaging, but 78481 represents one study and 78483 represents multiple studies.
- 78472Cardiac blood-pool imaging
- 78481 tracks the tracer during its first passage through the heart; 78472 is a single gated blood-pool study.
- 78494Cardiac blood-pool imaging
- 78481 uses first-pass acquisition, while 78494 is cardiac SPECT imaging.
78481 billing questions
When is 78481 used instead of 78483?
Use 78481 for a single first-pass cardiac function study. Use 78483 when multiple first-pass studies are performed.
Can the interpretation and imaging be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
What happens when other cardiovascular diagnostic procedures are performed?
CMS applies its cardiovascular diagnostic multiple-procedure reduction to the technical component. The reduction does not apply to the professional component under the supplied CMS rule.
How does 78481 differ from a gated blood-pool study?
78481 follows the tracer during its first passage through the heart. Gated blood-pool imaging, such as 78472, uses a different acquisition approach.
What should the report document?
Document that a single first-pass study was performed, the interpretation, and quantitative findings such as wall motion and ejection fraction.
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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