Summary & Overview
CPT 78430: PET Myocardial Perfusion Imaging, Rest or Stress
CPT code 78430 represents a PET myocardial perfusion imaging study with CT transmission scan used to evaluate myocardial blood flow and cardiac function. The code covers a single study performed at rest or with pharmacologic or exercise stress, and it may incorporate ejection fraction and ventricular wall motion assessment when those measurements are obtained. Nationally, PET myocardial perfusion imaging is an important advanced cardiac imaging modality for assessing ischemia, perfusion abnormalities, and ventricular function in patients with suspected or known coronary artery disease.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for CPT code 78430, benchmarks and utilization patterns where available, and an outline of common billing and coding considerations relevant to payers and providers. The publication summarizes service settings, typical clinical indications, and how CPT code 78430 fits within cardiac imaging service lines. Data on associated modifiers, taxonomies, and ICD‑10 diagnoses are not available in the input and are noted as such elsewhere in the full publication.
Billing Code Overview
CPT code 78430 describes a positron emission tomography (PET) myocardial perfusion imaging study performed with a CT transmission scan. The procedure evaluates blood flow to and from the heart (myocardial perfusion) and may include measurements of ejection fraction and ventricular wall motion when those studies are performed. The code applies to a single PET myocardial imaging study conducted at rest or with pharmacologic or exercise stress testing.
Service type: Cardiac nuclear imaging / PET myocardial perfusion study
Typical site of service: Outpatient imaging center or hospital-based radiology/nuclear medicine department, performed where PET/CT cardiac studies are available.
Clinical & Coding Specifications
Clinical Context
A 64-year-old male with a history of ischemic heart disease, prior percutaneous coronary intervention, and exertional angina is referred for a PET myocardial perfusion imaging study (78430) to assess regional myocardial blood flow and viability. The patient arrives fasting; baseline vitals and IV access are obtained. A radiopharmaceutical (commonly rubidium-82 or N-13 ammonia) is administered at rest and then during pharmacologic stress (e.g., regadenoson) or exercise if feasible. A combined PET with CT transmission scan is performed to acquire attenuation-corrected perfusion images. Left ventricular ejection fraction and ventricular wall motion are measured during the study if acquired. The interpreting physician reviews the PET images, CT attenuation data, and quantitative perfusion/ejection fraction results, documents findings and impression, and generates a report for the referring cardiologist.
Typical site of service: outpatient nuclear medicine suite, hospital-based imaging center, or cardiac catheterization department with PET capability.
Service type: diagnostic cardiac PET myocardial perfusion imaging with CT transmission (single study at rest or with stress).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation of the PET/CT study. |