`78459` Myocrd img pet single study

What 78459 is

CMS fee schedule short descriptor: Myocrd img pet single study.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 78459 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Medically Unlikely Edit (MUE)

Medicare caps 78459 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 78459? These codes are bundled into it

78459 is a Column 1 code in 26 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`0694T`	3d vol img&rcnstj brst/ax	1 - modifier may bypass	Check pair
`0708T`	Id ca immntx prep & 1st njx	1 - modifier may bypass	Check pair
`0709T`	Id ca immntx each addl njx	1 - modifier may bypass	Check pair
`36000`	Place needle in vein	1 - modifier may bypass	Check pair
`36005`	Injection ext venography	1 - modifier may bypass	Check pair
`36410`	Vnpnxr 3yr/> phy/qhp dx/ther	1 - modifier may bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`76376`	3d render w/intrp postproces	1 - modifier may bypass	Check pair
`76377`	3d render w/intrp postproces	1 - modifier may bypass	Check pair
`77790`	Radiation handling	0 - no modifier bypass	Check pair
`78445`	Vascular flow imaging	0 - no modifier bypass	Check pair
`96360`	Hydration iv infusion init	1 - modifier may bypass	Check pair
`96365`	Ther/proph/diag iv inf init	1 - modifier may bypass	Check pair
`96372`	Ther/proph/diag inj sc/im	1 - modifier may bypass	Check pair
`96374`	Ther/proph/diag inj iv push	1 - modifier may bypass	Check pair
`96375`	Tx/pro/dx inj new drug addon	1 - modifier may bypass	Check pair
`96376`	Tx/pro/dx inj same drug adon	1 - modifier may bypass	Check pair
`96377`	Applicaton on-body injector	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`A4641`	Radiopharm dx agent noc	0 - no modifier bypass	Check pair
`A9500`	Tc99m sestamibi	1 - modifier may bypass	Check pair
`A9502`	Tc99m tetrofosmin	1 - modifier may bypass	Check pair
`A9503`	Tc99m medronate	0 - no modifier bypass	Check pair
`A9526`	Nitrogen n-13 ammonia	1 - modifier may bypass	Check pair
`A9555`	Rb82 rubidium	1 - modifier may bypass	Check pair

78459 is bundled into these codes

78459 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 78459 is the code that denies.

Column 1 code	Short description
`78429`	Myocrd img pet 1 std w/ct	Check pair
`78430`	Myocrd img pet rst/strs w/ct	Check pair
`78432`	Myocrd img pet 2rtracer	Check pair
`78433`	Myocrd img pet 2rtracer ct	Check pair
`79101`	Nuclear rx iv admin	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.