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    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Cardiovascular SystemCPT cpt-78414-cardiac-perfusion-blood-flow-assessment
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    CPT 78414: Cardiac Perfusion and Ejection Fraction Assessment

    Medicare pays $22 on average nationally for this procedure.

    CPT code 78414 describes a diagnostic procedure that assesses central cardiovascular blood flow and evaluates left ventricular ejection fraction, often using an appropriate imaging probe or device and sometimes a pharmacologic stress agent to provoke flow changes; this service is a cardiac perfusion and ejection fraction assessment typically performed in an imaging or cardiac catheterization lab or similar diagnostic imaging facility as an advanced cardiovascular diagnostic study.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with a history of ischemic cardiomyopathy and worsening exertional dyspnea is referred for an assessment of left ventricular function. The cardiology team schedules a radionuclide ventriculography using an appropriate probe to quantify ejection fraction at rest and after pharmacologic stress to evaluate contractile reserve. The workflow includes pre-procedure consent, review of medications (holding interfering agents per local protocol), intravenous placement for radiotracer or pharmacologic agent administration, acquisition of baseline images to determine resting ejection fraction, administration of a vasodilator or inotrope to provoke coronary flow or contractility, repeat imaging to measure peak-change ejection fraction, and post-procedure monitoring for hemodynamic stability. Results are interpreted by a cardiologist or nuclear medicine physician and incorporated into the patient’s heart failure management plan.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78451Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, when performed); single study at rest and/or stress, only planar omittedOften performed alongside ventricular function assessment to evaluate perfusion and ischemia.
    93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, complete, with spectral Doppler and color flow Doppler when performedAlternative or complementary modality to assess ejection fraction and wall motion.
    93000Electrocardiogram, routine ECG with at least 12 leads; with interpretation and reportPerformed before stress imaging to document baseline rhythm and for safety during pharmacologic stress.
    93015Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ECG monitoring, and supervision, with interpretation and reportExercise stress testing may precede or substitute pharmacologic stress when patient is able to exercise.
    78452Myocardial SPECT, multiple studies including attenuation correction when performed; two studies (rest and stress), tomographicWhen perfusion SPECT is performed with gated acquisition to derive ejection fraction and wall motion as part of comprehensive assessment.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    207L00000X
    207RP1001X
    2084P0800X
    363A00000X
    376K00000X
    2279P1005X
    261QM0850X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 2

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-78428-LEFT-TO-RIGHT-CARDIAC-SHUNT-DETECTION

    CPT 78428: Detection of Left-to-Right Cardiac Shunt

    CPT-78429-PET-MYOCARDIAL-IMAGING-PET-CT-MYOCARDIUM-FUNCTION

    CPT 78429: PET Myocardial Imaging, Single Study

    CPT-78430-PET-MYOCARDIAL-PERFUSION-IMAGING-REST-OR-STRESS

    CPT 78430: PET Myocardial Perfusion Imaging with CT

    CPT-78431-PET-MYOCARDIAL-PERFUSION-IMAGING-REST-AND-STRESS

    CPT 78431: PET Myocardial Perfusion with CT Transmission, Rest and Stress

    CPT-78432-PET-MYOCARDIAL-PERFUSION-METABOLIC-VIABILITY

    CPT 78432: PET Myocardial Perfusion and Viability Imaging

    CPT-78433-PET-MYOCARDIAL-PERFUSION-METABOLIC-IMAGING-CT

    CPT 78433: PET Myocardial Imaging for Perfusion and Metabolism

    CPT-78434-PET-MYOCARDIAL-PERFUSION-REST-AND-STRESS

    CPT 78434: PET Myocardial Blood Flow Study, Rest and Stress

    CPT-78445-ANGIOGRAPHY-VENOGRAPHY-DIAGNOSTIC-VASCULAR-IMAGING

    CPT 78445: Angiography/Venography Blood Flow Imaging

    CPT-78451-SINGLE-SPECT-MYOCARDIAL-PERFUSION-STUDY

    CPT 78451: Myocardial Perfusion SPECT, Single Study

    CPT-78452-CARDIAC-PERFUSION-SPECT-MULTIPLE-STUDIES

    CPT 78452: Myocardial Perfusion SPECT, Multiple Studies

    Showing 1–10 of 28

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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