Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Cardiovascular SystemCPT cpt-78451-single-spect-myocardial-perfusion-study
    Ask Trek AI about this page

    CPT 78451: Myocardial Perfusion SPECT, Single Study

    Medicare pays $217 on average nationally for this procedure.

    CPT code 78451 describes a single myocardial perfusion SPECT study performed to identify areas of the heart with deficient blood flow; the service is a nuclear cardiology imaging study (myocardial perfusion imaging) typically performed in an outpatient imaging center or hospital nuclear medicine department to evaluate regional myocardial perfusion and ischemia.

    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).

    Customize your policy alerts

    Sign up for cpt 78451 policy alerts

    Get alerted when payer policies referencing 78451 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with chronic exertional angina and multiple cardiovascular risk factors (hypertension, hyperlipidemia, former smoker) is referred by his cardiologist for a single-photon emission computed tomography (SPECT) myocardial perfusion study to evaluate for areas of reversible ischemia. The patient arrives at an outpatient nuclear cardiology imaging center. After consent and screening for contraindications to pharmacologic stress (if treadmill not feasible), a radiopharmaceutical (typically technetium-based) is administered at rest and during stress. Continuous ECG and blood pressure monitoring occur during stress, and nuclear camera acquisition captures gated SPECT images of myocardial perfusion. Images are reconstructed and interpreted by a cardiology or nuclear medicine physician to identify regions of deficient blood flow and guide further management such as medical therapy optimization or invasive coronary angiography.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78451Single SPECT study of the heart to determine areas of deficient blood flowPrimary procedure: gated SPECT myocardial perfusion imaging to identify ischemia and infarction.
    93000Electrocardiogram, routine ECG with at least 12 leads; with interpretation and reportOften performed before or during stress testing to document baseline rhythm and ischemic changes.
    93018Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ECG monitoring, and supervisionPerformed as the stress component if the patient can exercise; paired clinically with SPECT imaging.
    93015Cardiovascular stress test using pharmacologic stress agentWhen pharmacologic stress (adenosine, regadenoson) is required instead of exercise for SPECT imaging.
    78831Myocardial perfusion imaging, tomographic (SPECT), multiple studies, with reportAlternative SPECT codes for studies with multiple phases or complex protocols; may be used depending on protocol.

    Related Modifiers

    6 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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    207RC0000X
    207Q00000X
    1835P1400X
    2084P0301X
    332100000X
    2278P4000X
    176B00000X

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E11.9Type 2 diabetes mellitus without complications
    E66.9Obesity, unspecified
    E78.5Hyperlipidemia, unspecified
    I20.0Unstable angina
    I20.9Angina pectoris, unspecified
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I21.4Non-ST elevation (NSTEMI) myocardial infarction
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris

    Showing 1–10 of 28

    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-78414-CARDIAC-PERFUSION-BLOOD-FLOW-ASSESSMENT

    CPT 78414: Cardiac Perfusion and Ejection Fraction Assessment

    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-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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.