CPT code 78433 represents PET myocardial imaging using two radionuclide tracers with a concurrent CT transmission scan to assess both myocardial perfusion and metabolic activity, including viability and, when performed, ejection fraction and ventricular wall motion. This advanced imaging modality contributes to cardiac diagnostics by combining perfusion and metabolic information in a single study, supporting assessment of ischemia, viability, and planning for coronary or myocardial interventions. Nationally, PET myocardial imaging is increasingly relevant as PET/CT platforms and tracer availability expand across outpatient imaging centers and hospitals.

Key payers examined in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage and billing considerations, common modifiers used with nuclear cardiology imaging, the typical clinical context for ordering this study, and benchmarking and coding guidance where available. The publication also outlines service line implications for hospital outpatient departments and specialized imaging centers and highlights clinical scenarios in which combined perfusion and metabolic PET/CT informs patient management. Data not available in the input are noted in the relevant sections.