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.

    v1.0.28
    OpenPayerBilling CodesDiagnostic Nuclear Medicine Procedures on the Cardiovascular SystemCPT cpt-78453-cardiac-planar-perfusion-study-2d
    Ask Trek AI about this page

    CPT 78453: Single-Planar Nuclear Cardiac Perfusion Study

    Medicare pays $183 on average nationally for this procedure.

    CPT code 78453 describes a single-planar nuclear cardiac perfusion study that produces two-dimensional (2D) planar images to detect areas of deficient myocardial blood flow; the service is a diagnostic cardiac imaging procedure typically performed in an outpatient imaging center or hospital nuclear medicine department to evaluate regional myocardial perfusion.

    For related coverage guidance, see recent payer policy updates: Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA), Cardiovascular Disease Risk Assessment, Biomarkers for Myocardial Infarction and Chronic Heart Failure.

    Customize your policy alerts

    Sign up for cpt 78453 policy alerts

    Get alerted when payer policies referencing 78453 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
    • 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 typical patient is a 62-year-old male with exertional chest pain and known coronary artery disease referred by cardiology for a myocardial perfusion planar imaging study to evaluate areas of deficient blood flow to the myocardium. The patient presents to a hospital nuclear medicine department or an outpatient imaging center. After initial intake and review of indications and medications, an IV radiotracer (commonly technetium-labeled agent) is administered. Rest and/or stress imaging protocols are performed with single planar (2D) images acquired to localize perfusion defects. Images are interpreted by a nuclear cardiologist or cardiologist with nuclear medicine competency, and a report documents areas of reduced perfusion, comparison to prior studies if available, and correlation with clinical presentation. Typical site of service is an outpatient imaging center or hospital outpatient department; inpatient performance can occur for hospitalized cardiac patients. The clinical workflow includes pre-test screening, tracer injection, appropriate timing for image acquisition, acquisition of planar 2D images, image processing, physician interpretation, and generation of the final report for the referring provider.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78453Myocardial perfusion imaging, single study, planar (2D)Primary code for single planar myocardial perfusion study to identify areas of deficient blood flow.
    78491Radionuclide imaging for ventricular ejection fraction, first studyOften performed alongside perfusion imaging to assess ventricular function.
    78492Radionuclide imaging for ventricular ejection fraction, subsequent studyUsed for serial assessment of ejection fraction in the same encounter or follow-up.
    78465Myocardial perfusion imaging, tomographic (SPECT) study; single day imaging protocol, including imaging and interpretationAlternative or complementary modality when tomographic (3D SPECT) imaging is indicated or available.
    93000Electrocardiogram, routine ECG with at least 12 leads; with interpretation and reportPerformed prior to stress imaging to assess rhythm and safety for stress testing.

    Related Modifiers

    5 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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    207T00000XNeurological Surgery PhysicianA neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and reh…
    2080P0210XPediatric Nephrology PhysicianA pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney c…
    3747P1801XPersonal Care AttendantAn individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. …
    163WD0400XDiabetes Educator Registered NurseNursing Service Providers · Registered Nurse
    225B00000XPulmonary Function TechnologistAn individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
    2251P0200XPediatric Physical TherapistA licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has d…
    207NP0225XPediatric Dermatology PhysicianA pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emph…

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    E11.22Type 2 diabetes mellitus with diabetic chronic kidney disease
    E78.5Hyperlipidemia, unspecified
    I20.0Unstable angina
    I20.9Angina pectoris, unspecified
    I21.01ST elevation (STEMI) myocardial infarction involving left main coronary artery
    I21.02ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
    I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
    I21.3ST elevation (STEMI) myocardial infarction of unspecified site
    I21.4Non-ST elevation (NSTEMI) myocardial infarction
    I21.9Acute myocardial infarction, unspecified

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Cardiology1 / 2

    10 rows

    PolicyPayerEffective Date
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    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
    Cardiovascular Disease Risk Assessmentblue cross blue shield - louisiana2026-09-15
    Cardiovascular Disease Risk AssessmentBlue Cross Blue Shield - New Mexico2026-09-04
    Computed Tomography to Detect Coronary Artery CalcificationBluecross Idaho2026-09-01
    Intracoronary Drug Delivery Balloon ProceduresBlue Cross Blue Shield - Rhode Island2026-09-01
    Cardiac Imaging Guidelinesevicore2026-09-01
    Percutaneous Left Atrial Appendage Closure Device for Stroke PreventionAmbetter Georgia2026-08-26

    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.
    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.