Radiology · CMS status A
78451
Myocardial perfusion imaging, single study
Myocardial perfusion imaging (MPI), single study, single rest or stress, planar or SPECT. CMS 2026 global wRVU 1.46, total RVU approximately 6.06, Medicare global allowable approximately $202. The cardiac perfusion test used to assess ischemia, viability, and myocardial blood flow.
Work RVU
1.46
2026 Medicare pays
$202.41
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.46 + Practice 4.50 + Malpractice 0.10 = 6.06 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 78451 is locked
- When to use it: the exact clinical situations that support billing 78451
- Documentation checklist: the 6 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 78451 downcoded or denied
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Common modifiers
26TC
Common ICD-10 pairings
R07.9I20.9I25.10I50.20
Payer notes
Medicare covers 78451 / 78452 with appropriate indication. Outpatient prior authorization is common for commercial payers; ED studies are usually post-care approved. Appropriate-use criteria (AUC) from ACC/SCCT apply: payers may deny when imaging is ordered for low-risk asymptomatic patients without abnormal stress EKG.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.