CPT 78414Radiology

Non-imaging heart function

CPT code 78414 is used for a non-imaging heart function test that measures how well your heart pumps blood without creating pictures. This nuclear medicine study calculates your heart's ejection fraction using radioactive tracers detected by special equipment.

Showing rates for

National Average

Base Medicare rate

$20.05

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.45

PE RVU (NF)

0.16

MP RVU

0.01

Total RVU

0.62

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify that 78414 is not bundled into other nuclear cardiology imaging codes (78451-78454) when performed during the same session
Impact: Prevents claim denials and reduces revenue loss of $20.05 per incorrectly unbundled service; most payers bundle non-imaging with imaging studies
Document the specific clinical indication for non-imaging assessment when performed separately from imaging studies
Impact: Increases claim acceptance rate by 30-40% when medical necessity is clearly established for standalone non-imaging function testing
Confirm radiotracer dosage, administration time, and acquisition parameters are documented in the procedure report
Impact: Essential for audits; missing radiotracer documentation is the leading cause of claim recoupment in nuclear medicine billing
Bill on the date of service when data acquisition occurs, not when interpretation is completed
Impact: Avoids timely filing issues and ensures proper date-of-service coding; prevents automatic denials for late submissions
Use appropriate ICD-10 codes linking cardiac function assessment to the underlying condition (heart failure, chemotherapy monitoring, cardiomyopathy)
Impact: Improves first-pass claim acceptance by 25%; codes like I50.9, Z79.899, or I42.9 provide clear medical necessity
For hospital outpatient departments, ensure charge capture includes both professional and technical components with appropriate place of service codes
Impact: Prevents revenue leakage; facility setting requires POS 22, proper revenue codes, and may affect the $20.05 reimbursement distribution

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 78414?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is CPT code 78414 used for in nuclear cardiology?

CPT 78414 is used for non-imaging cardiac function studies that measure how well the heart pumps blood using radioactive tracers. The procedure calculates ejection fraction and other functional parameters without producing diagnostic images, typically using gated equilibrium or first-pass techniques. It's commonly performed for chemotherapy monitoring, heart failure assessment, or when only quantitative functional data is needed without anatomical imaging.

How much does Medicare pay for CPT 78414 in 2025?

Medicare pays $20.05 for CPT 78414 in 2025 based on the national average rate for both facility and non-facility settings. The code has a total RVU of 0.62 (Work RVU: 0.45, PE RVU: 0.16, MP RVU: 0.01) multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary based on geographic adjustments and individual carrier policies.

Can CPT 78414 be billed with cardiac imaging codes like 78451?

Generally, CPT 78414 cannot be separately billed with comprehensive cardiac imaging codes (78451-78454) performed during the same session, as most payers consider the non-imaging function assessment bundled into the comprehensive study. However, if performed as a distinct separate service with clear medical necessity and proper documentation, modifier 59 may support separate billing. Always verify payer-specific bundling edits before billing both codes together.

What modifiers are commonly used with CPT 78414?

The most applicable modifiers for 78414 include modifier TC (technical component only) in split billing arrangements, modifier 59 (distinct procedural service) when performed separately from bundled procedures, and modifier 91 (repeat clinical diagnostic test) for medically necessary serial measurements on the same day. Modifier 26 is rarely applicable since 78414 is primarily a technical component code with minimal professional work.

What documentation is required to bill CPT 78414?

Required documentation includes clinical indication for the study, radiotracer type and dosage in mCi, administration route and time, acquisition protocol details, quantitative results (especially ejection fraction), technologist credentials and signature, and physician supervision documentation. Equipment quality control records and patient consent for radioactive material administration should also be maintained. Missing radiotracer documentation is the most common reason for claim denials and audit recoupment.

Who can perform and bill for CPT 78414 procedures?

CPT 78414 can be billed by nuclear medicine physicians, cardiologists with nuclear cardiology training, and radiologists who supervise the technical component. The procedure must be performed by certified nuclear medicine technologists (NMTCB or ARRT(N)), and the facility must hold appropriate radioactive material licenses. Common billing settings include hospital outpatient departments, dedicated cardiac imaging centers, and nuclear medicine laboratories.

What are the RVU values for CPT 78414 in 2025?

The 2025 RVU values for CPT 78414 are: Work RVU 0.45, Practice Expense (PE) RVU 0.16 for both facility and non-facility settings, and Malpractice (MP) RVU 0.01, totaling 0.62 RVUs. These values are multiplied by the 2025 conversion factor of 32.3465 to calculate the Medicare payment rate of $20.05. The low work RVU reflects that this is primarily a technical procedure with minimal physician work in most billing scenarios.