CPT 78452
Global XXX ActiveHt muscle image spect mult
CPT 78452 Billing & Documentation Guide
CPT code 78452 (Ht muscle image spect mult) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.58, a non-facility practice expense RVU of 11.1, and a malpractice RVU of 0.13, a total non-facility RVU of 12.81 and facility RVU of 12.81. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $444.5, though rates vary from $373.48 to $595.53 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 78452, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 78452 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 78452 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 78452
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.58 | 1.58 |
| Practice Expense RVU | 11.1 | 11.1 |
| Malpractice RVU | 0.13 | 0.13 |
| Total RVU | 12.81 | 12.81 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 78452
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $495.72 | $495.72 | $462.34 - $595.53 | 29 |
| Florida | $433.21 | $433.21 | $413.74 - $449.71 | 3 |
| Georgia | $411.75 | $411.75 | $388.66 - $434.83 | 2 |
| Illinois | $419.49 | $419.49 | $398.05 - $441.6 | 4 |
| Michigan | $407.02 | $407.02 | $396.17 - $417.87 | 2 |
| North Carolina | $401.46 | $401.46 | $401.46 - $401.46 | 1 |
| New York | $474.79 | $474.79 | $408.04 - $505.04 | 5 |
| Ohio | $395.65 | $395.65 | $395.65 - $395.65 | 1 |
| Pennsylvania | $421.04 | $421.04 | $397.23 - $444.85 | 2 |
| Texas | $422.1 | $422.1 | $394.19 - $448.98 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 78452
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 78452 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0541T | Column 1 (primary), can be billed with modifier | No | More extensive procedure |
| 0542T | Column 1 (primary), can be billed with modifier | No | More extensive procedure |
| 0694T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 78452
What does CPT code 78452 mean? +
CPT code 78452 represents: Ht muscle image spect mult. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 78452? +
The 2026 Medicare national average non-facility payment for CPT 78452 is $444.5. Rates range from $373.48 to $595.53 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 78452? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 78452? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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