How much does Medicare pay for CPT 78452?

Medicare allowed an average of $233.43 per service and paid $181.65 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $830.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 78452?

Nuclear medicine studies of heart muscle at rest and with stress and spect. It was billed 1,209,154 times to 1,197,607 Medicare beneficiaries by 14,635 providers in 2024.

Does 78452 pay differently in an office than a hospital?

Yes. The allowed amount averaged $371.07 in an office setting and $73.09 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 78452 most?

Cardiology, with 851,294 services from 9,373 clinicians. Next are Interventional Cardiology, Diagnostic Radiology, Internal Medicine.

CPT 78452

Nuclear medicine studies of heart muscle at rest and with stress and spect

$233.43Medicare-allowed amount per service, averaged across 1,209,154 services

Providers submitted

$830.58

Asking price, not received

Medicare allowed

$233.43

The fee schedule figure

Medicare paid

$181.65

Balance is patient coinsurance

Providers submitted an average of $830.58 for this code and Medicare allowed $233.43 — 3.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $181.65 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $371.07
Hospital / facility: $73.09

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 650,644 services were billed in an office setting and 558,510 in a facility.

Services: 1,209,154
Beneficiaries: 1,197,607
Providers billing it: 14,635
Total allowed: $282,252,818

What Medicare pays for CPT 78452

Across 1,209,154 services billed by 14,635 providers to 1,197,607 beneficiaries, Medicare allowed an average of $233.43 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 78452

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	851,294	842,521	$251.49	9,373
Interventional Cardiology	159,006	157,625	$239.69	1,998
Diagnostic Radiology	95,348	95,098	$90.53	1,827
Internal Medicine	45,132	44,251	$211.07	646
Nuclear Medicine	29,635	29,515	$150.84	266
Clinical Cardiac Electrophysiology	9,978	9,893	$307.64	170
Advanced Heart Failure and Transplant Cardiology	5,201	5,198	$146.48	83
Interventional Radiology	2,849	2,844	$112.19	61
Family Practice	2,370	2,349	$326.87	82
Independent Diagnostic Testing Facility (IDTF)	1,954	1,945	$400.48	23
Cardiac Surgery	1,249	1,247	$228.94	15
Hospitalist	1,214	1,205	$344.79	16
Nurse Practitioner	780	778	$246.72	22
Physician Assistant	541	539	$288.53	9
Undefined Physician type	425	425	$395.17	5

78452 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	121,351	$313.80	$250.94	1,331
California	102,986	$311.44	$212.38	1,154
Texas	89,111	$269.02	$217.90	1,173
New York	76,065	$348.35	$239.21	873
New Jersey	53,933	$302.16	$212.35	642
Illinois	49,076	$172.61	$131.30	559
Pennsylvania	42,729	$163.44	$126.70	690
Georgia	40,449	$220.94	$179.80	520
Ohio	40,332	$122.31	$99.42	530
Arizona	38,362	$335.70	$267.98	359
North Carolina	35,534	$212.44	$175.38	463
Michigan	35,114	$196.84	$154.87	487
Virginia	34,392	$211.67	$162.70	396
South Carolina	34,114	$222.82	$185.27	283
Maryland	32,934	$396.21	$287.86	280
Tennessee	32,824	$154.24	$127.64	364
Indiana	27,945	$104.71	$83.98	351
Massachusetts	27,419	$198.58	$140.75	331
Missouri	20,084	$104.62	$83.23	260
Oklahoma	19,218	$99.08	$81.32	171
Kentucky	18,555	$121.57	$98.03	242
Wisconsin	17,944	$126.32	$100.30	246
Washington	17,665	$132.32	$97.56	260
Alabama	17,441	$235.34	$207.62	233
Kansas	17,224	$187.79	$157.15	164
Louisiana	16,447	$241.32	$210.55	235
Arkansas	15,216	$107.43	$89.30	146
Mississippi	12,246	$197.69	$171.02	130
Iowa	10,979	$134.75	$110.24	126
Nevada	10,928	$278.27	$224.99	162
Connecticut	10,131	$228.97	$163.29	200
Colorado	10,086	$128.87	$96.52	160
Delaware	8,627	$290.93	$230.46	57
Minnesota	8,436	$86.73	$65.29	187
Nebraska	8,176	$173.82	$147.39	83
West Virginia	7,495	$154.32	$130.42	88
South Dakota	6,251	$71.94	$55.59	40
Oregon	6,040	$149.19	$114.74	119
New Hampshire	4,873	$76.23	$57.51	75
Idaho	4,619	$96.74	$78.54	52
New Mexico	4,124	$152.35	$127.96	53
Maine	2,815	$80.38	$60.58	77
North Dakota	2,618	$79.63	$61.87	37
District of Columbia	2,604	$428.95	$286.61	37
Utah	2,513	$153.63	$123.58	45
Montana	2,090	$89.63	$69.23	31
Rhode Island	2,051	$238.22	$175.19	33
Wyoming	1,802	$304.57	$230.50	22
Alaska	1,426	$299.89	$201.24	23
Vermont	1,422	$85.00	$64.78	18
Hawaii	935	$174.25	$126.63	17
Puerto Rico	898	$262.32	$198.72	18
Guam	486	$433.81	$322.50	1
AA	19	$72.21	$59.39	1

Related codes

78431Nuclear medicine studies of blood flow in heart muscle at rest and$1606.23
78434Nuclear medicine study of heart muscle blood flow by pet$292.41
78492Nuclear medicine studies of blood flow in heart muscle at rest and$1331.27
78451Nuclear medicine study of heart muscle at rest and$122.96
78454Nuclear medicine studies of heart muscle at rest and$61.60
78472Nuclear medicine study of heart pumping function by labeling red blood$123.30

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.