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    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Cardiovascular SystemCPT cpt-78452-cardiac-perfusion-spect-multiple-studies
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    CPT 78452: Myocardial Perfusion SPECT, Multiple Studies

    Medicare pays $298 and commercial payers pay $1125 on average nationally for this procedure.

    CPT code 78452 describes a multiple SPECT myocardial perfusion imaging study performed to identify areas of deficient myocardial blood flow; the service is a nuclear cardiology diagnostic imaging procedure typically provided in an outpatient imaging center, hospital nuclear medicine department, or cardiac catheterization lab setting to assess regional myocardial perfusion.

    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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    National Reimbursement Benchmarks

    Commercial averages substantially exceed Medicare for CPT 78452: BUCA’s mean commercial rate of $1,124.70 is roughly 3.8 times higher than Medicare’s mean of $297.80, highlighting a sizable premium in the commercial market versus the federal baseline. Blue Cross Blue Shield and UnitedHealth Group also show notably higher mean rates ($1,659.30 and $470.40 respectively) while Cigna and Aetna sit between those poles. This positions Medicare near the lower end of national averages and BUCA near the upper end of commercial pricing for this code.

    Rate dispersion (P75 minus P25) varies markedly by payer. Blue Cross Blue Shield has the widest interquartile spread at $759.30, reflecting the greatest pricing variability among commercial payers, followed by UnitedHealth Group at $430.50. Cigna’s spread is $500.10 and BUCA’s interquartile range is $625.00, while Aetna is the tightest at $352.00. Medicare’s IQR is $346.00, indicating relatively moderate locality-driven variation compared with several commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 64-year-old male with a history of hypertension and known coronary artery disease presents with worsening exertional chest pain and dyspnea. He was admitted after an emergency department visit for acute chest pain and troponin elevation; an ECG raised concern for possible ST-elevation myocardial infarction. After initial stabilization and review by cardiology, the patient undergoes a multi-phase myocardial perfusion SPECT study to evaluate regional myocardial blood flow and identify areas of reversible ischemia versus infarction. The imaging sequence includes rest and stress SPECT acquisitions, with pharmacologic stress when the patient cannot exercise due to dyspnea and recent heart failure decompensation.

    The typical clinical workflow includes: triage and indication confirmation by the ordering cardiologist or nuclear medicine physician; review of relevant ICD-10 diagnoses such as I21.9, I21.A1, or I50.810; pre-procedure evaluation for contraindications to stress agents; radiopharmaceutical administration; acquisition of gated SPECT images; image processing and interpretation by a qualified nuclear medicine physician or cardiologist; and documentation of findings describing perfusion defects, ejection fraction, and recommendations for further management. Results are communicated to the referring cardiovascular disease or interventional cardiology team for linkage to revascularization planning or medical therapy adjustments.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    10 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…
    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…
    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…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    207RI0011X
    207R00000X
    2085R0202X
    207ZP0102X
    126900000X
    103TP0016X
    1835C0207X

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

    CPT 78451: Myocardial Perfusion SPECT, Single Study

    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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    93306Transthoracic echocardiography, completeOften performed to assess cardiac structure and function before or after perfusion imaging; complementary data on wall motion and ejection fraction.
    93017Cardiovascular stress testFrequently paired with stress SPECT studies; exercise or pharmacologic stress test provides the physiologic challenge for detecting inducible ischemia.