$283.55
78456 is directed to acute venous thrombosis imaging. Choose 78445 for a vascular flow study that is not specifically an acute thrombus examination.
On this page
CMS RVU26D · Effective 2026-10-01
78445 Vascular flow study Medicare reimbursement rates in Wyoming
Reports radionuclide imaging used to assess blood flow through a selected vascular territory when clinicians need a functional flow study. Compare 78445 office and facility rates across CMS payment localities in Wyoming.
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 78445 in Wyoming?
Wyoming 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
$166.40
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 medicine
About 78445: Nuclear medicine vascular flow study
Reports radionuclide imaging used to assess blood flow through a selected vascular territory when clinicians need a functional flow study.
This nuclear medicine study uses a radiotracer and imaging to assess blood movement through a selected vascular territory. It may be ordered when a clinician is evaluating suspected impaired circulation, including limb perfusion concerns. Nuclear medicine technologists acquire the study, and a qualified physician interprets the images. The service is generally performed in a hospital or other diagnostic imaging facility.
Report 78445 for the vascular flow imaging service, supported by documentation identifying the clinical indication, vascular territory examined, imaging performed, and physician interpretation. The code has professional and technical components: report modifier 26 for the interpretation, TC for the equipment and staff, or no modifier for the global service. When multiple cardiovascular diagnostic procedures are performed, the multiple procedure reduction applies to the technical component.
CMS billing rules for 78445
- 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 RVU0.48 · 10%
- Practice expense (office) RVU4.45 · 89%
- Malpractice RVU0.07 · 1%
49
Medicare services in 2024 · #5370 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.
78445 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$166.73
78457 describes venous thrombosis imaging focused on venous flow. 78445 is the broader vascular flow study selection.
$185.26
78458 is the bilateral venous thrombosis imaging option. 78445 is not distinguished by a bilateral venous thrombosis study.
Compare 78445 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
Wyoming** →
Office / nonfacility
$166.40
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 78445 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
9,362
- Code
- 78445
- Physician work
- 0.48
- Practice expense
- 4.45
- Malpractice
- 0.07
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.000 | 0.4800 |
| Practice expense | 4.45 | × 1.000 | 4.4500 |
| Malpractice | 0.07 | × 0.740 | 0.0518 |
| Total RVUs | 4.9818 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$166.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.48 | 1 |
| Practice expense | 4.45 | 1 |
| Malpractice | 0.07 | 0.74 |
(0.48 × 1 + 4.45 × 1 + 0.07 × 0.74) × $33.4009 = $166.40
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.
78445 billing questions
When is 78445 preferable to venous thrombosis imaging?
Use 78445 for a vascular flow study. When the clinical question is specifically venous thrombosis, compare the dedicated thrombosis imaging options, such as 78456 or 78457.
How should the professional and technical portions be reported?
Use modifier 26 for the physician's interpretation and TC for the technical service. Reporting without either modifier represents the global service.
Does the multiple procedure reduction affect both components?
The cardiovascular diagnostic multiple procedure reduction applies to the technical component when multiple qualifying procedures are performed.
What documentation supports reporting 78445?
Document the reason for the study, the vascular territory imaged, the imaging performed, and the physician's interpretation of the flow findings.
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.
9,35978434,,Aqmbf pet rest & rx stress,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,36078434,26,Aqmbf pet rest & rx stress,A,,0.61,0.23,,0.23,,0.02,0.86,0.86,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9,36178434,TC,Aqmbf pet rest & rx stress,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,