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78491 Myocrd img pet 1std rst/strs

What 78491 is

CMS fee schedule short descriptor: Myocrd img pet 1std rst/strs.

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 78491 (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.

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Medically Unlikely Edit (MUE)

Medicare caps 78491 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 78491? These codes are bundled into it

78491 is a Column 1 code in 25 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 codeShort descriptionModifier indicator
0694T3d vol img&rcnstj brst/ax1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
36000Place needle in vein1 - modifier may bypassCheck pair
36005Injection ext venography1 - modifier may bypassCheck pair
36410Vnpnxr 3yr/> phy/qhp dx/ther1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
763763d render w/intrp postproces1 - modifier may bypassCheck pair
763773d render w/intrp postproces1 - modifier may bypassCheck pair
77790Radiation handling0 - no modifier bypassCheck pair
78445Vascular flow imaging0 - no modifier bypassCheck pair
96360Hydration iv infusion init1 - modifier may bypassCheck pair
96365Ther/proph/diag iv inf init1 - modifier may bypassCheck pair
96372Ther/proph/diag inj sc/im1 - modifier may bypassCheck pair
96374Ther/proph/diag inj iv push1 - modifier may bypassCheck pair
96375Tx/pro/dx inj new drug addon1 - modifier may bypassCheck pair
96376Tx/pro/dx inj same drug adon1 - modifier may bypassCheck pair
96377Applicaton on-body injector1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
A4641Radiopharm dx agent noc0 - no modifier bypassCheck pair
A9500Tc99m sestamibi1 - modifier may bypassCheck pair
A9540Tc99m maa0 - no modifier bypassCheck pair
A9552F18 fdg1 - modifier may bypassCheck pair
A9558Xe133 xenon 10mci0 - no modifier bypassCheck pair

78491 is bundled into these codes

78491 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 78491 is the code that denies.

Column 1 codeShort descriptionModifier indicator
78431Myocrd img pet rst&strs ct0Check pair
78433Myocrd img pet 2rtracer ct0Check pair
78434Aqmbf pet rest & rx stress0Check pair
78492Myocrd img pet mlt rst&strs0Check pair
79101Nuclear rx iv admin0Check 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.