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See a sample rate comparisonCPT 78491 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Myocrd Img Pet 1std Rst Strs, Myocardial Imaging Positron Emission Tomography Pet Perfusion Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Single Study At Rest Or Stress Exercise Or Pharmacologic
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Nuclear Medicine Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 78491 |
| Medicaid Fee Schedule | View Medicaid rates for 78491 |
National average reimbursement for CPT 78491 by major payers:
$873.21
$1,461.04
$1,353.77
$1,158.24
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CPT 78491
5 of 25 sample ratesHigher to lower in this preview
Saint Clare Hospital, St. Clare Hospital
$5,491.41Published rateAllen Chen
Skagit Radiology, Inc., P.S.
$2,671.44Published rateUPMC Western Maryland Corporation, Western Maryland Outpatient Diagnostic Center
UPMC Western Maryland Corporation
$1,900.00Published rateBaaxten, LLC, Baaxten Imaging Center
$1,260.25Published rateAllen Chen
Skagit Radiology, Inc., P.S.
$135.89Published rate
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See a sample payer proposalCPT 78491 vs. Other Nuclear Medicine Procedures Codes
The CPT 78491 code is part of the Radiology Procedures services used for Nuclear Medicine Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 78491 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 78466-CPT | Moderate | Heart Scan After Heart Attack, A Radioactive Substance Is Injected And Its Movement Through The Heart Is Recorded By A High-Energy Camera For Several Heart Cycles. The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury. |
| 78468-CPT | Moderate | Heart Scan After Heart Attack, A Radioactive Substance Is Injected And Its Movement Through The Heart Is Recorded By A High-Energy Camera For Several Heart Cycles. The Procedure Helps To Identify The Extent And Location Of Any Heart Muscle Injury. |
| 78491-CPT | Moderate | Myocrd Img Pet 1std Rst Strs, Myocardial Imaging Positron Emission Tomography Pet Perfusion Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Single Study At Rest Or Stress Exercise Or Pharmacologic |
| 78492-CPT | High | Myocrd Img Pet Mlt Rst Strs, Myocardial Imaging Positron Emission Tomography Pet Perfusion Study Including Ventricular Wall Motion S And Or Ejection Fraction S When Performed Multiple Studies At Rest And Stress Exercise Or Pharmacologic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78491. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78491 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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