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CMS RVU26D · Effective 2026-10-01

78452 Nuclear stress test Medicare reimbursement rates in Wisconsin

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 Wisconsin.

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 Wisconsin?

Wisconsin 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

$409.29

1 of 1 localities have a supported rate.

Payment area: Wisconsin

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.

Find 78452 in your payment locality →

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 Wisconsin, from the same CMS release.

78451

Cardiac SPECT

Single rest or stress study

$297.94

Choose 78451 for one SPECT perfusion study. Choose 78452 for multiple distinct studies, such as rest and stress or studies involving redistribution or reinjection.

78454

Heart imaging

Multiple planar studies

$364.86

Choose 78454 when multiple perfusion studies use planar imaging without tomographic reconstruction. Choose 78452 when SPECT tomographic imaging is used.

78492

Myocrd img pet mlt rst&strs

No office rate

Choose 78492 for multiple-study PET perfusion imaging. Choose 78452 when the multiple perfusion studies use SPECT.

78473

Gated heart imaging

Multiple studies

$255.28

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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 78452 in Wisconsin.

PPRRVU2026_Oct_nonQPP.csv

9,368

Code
78452
Physician work
1.58
Practice expense
11.10
Malpractice
0.13

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office / nonfacility calculation for 78452 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work1.58× 1.0001.5800
Practice expense11.10× 0.95810.6338
Malpractice0.13× 0.3080.0400
Total RVUs12.2538
Conversion factor× 33.4009

Office / nonfacility rate, Wisconsin$409.29

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.581
Practice expense11.10.958
Malpractice0.130.308

(1.58 × 1 + 11.1 × 0.958 + 0.13 × 0.308) × $33.4009 = $409.29

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.

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.

RVUs for 78452PPRRVU2026_Oct_nonQPP.csv, line 9,368 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)