Nuclear Stress Test Cost
Ht muscle image spect mult
$1,397Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, a nuclear stress test costs about $1,397 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $428 covers the whole test, and a ZIP code adjusts every figure to your area.
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- ✓The add-on codes that typically land on the bill
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National Medicare physician rate (2026)
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
This is Medicare's separate payment to the facility on top of the physician's fee. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Get the rate for your ZIP
CMS adjusts this CPT by locality. A five-digit ZIP is enough: no account, no insurance card.
What nuclear stress test costs at hospitals near you
Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 90001.
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What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. For this code the office and hospital physician lines differ by $353.39.
How CMS prices CPT 78452
Work is about 12% of the office total RVU; practice expense is about 87%. Localities with a high PE GPCI move this code more when practice expense is a large share.
Office vs hospital for this code
Office (non-facility) physician rate: $427.87. Hospital (facility) physician rate: $74.48.
Medicare patients typically owe 20% of the allowed amount after the Part B deductible, about $86 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.
Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.
Nuclear Stress Test cost by state
2026 Medicare non-hospital rate for CPT 78452, averaged across each state's localities. Open a state for its locality table and full cost breakdown.
What Is Nuclear Stress Test?
A nuclear stress test (SPECT myocardial perfusion imaging) shows how well blood reaches your heart muscle at rest versus under stress, revealing blocked arteries. A small amount of radioactive tracer is injected, a special camera images the heart at rest, then you exercise on a treadmill or receive a medication that mimics exercise, and imaging repeats. Plan for a half day; the multiple imaging sessions and waiting periods make it one of the longest routine cardiac tests.
What Affects the Cost
- –The radioactive tracer is a significant supply cost billed alongside the imaging, and tracer prices fluctuate with supply shortages.
- –Pharmacologic stress agents, used for patients who cannot exercise, are expensive drugs billed as additional lines.
- –Hospital outpatient cardiology departments charge substantially more than office-based nuclear labs.
- –Abnormal results commonly lead to cardiac catheterization, a much larger downstream expense.
- –The supervising cardiologist's stress supervision fee and the imaging interpretation fee are separate professional charges.
How It Is Billed
CPT 78452 covers the multi-session SPECT imaging at rest and stress; the stress portion itself (treadmill supervision or drug administration) bills under separate cardiology codes, the tracer bills as a radiopharmaceutical supply, and any pharmacologic stress drug adds its own line. A complete claim therefore stacks four or more components, which is why quotes that mention only the imaging code understate the real total. Hospital settings add a facility fee on top.
Insurance & Coverage Notes
Commercial insurers almost universally require prior authorization for nuclear stress testing and increasingly push lower-risk patients toward cheaper alternatives like exercise ECG or stress echocardiography first; expect the request to be reviewed against appropriate-use criteria. Medicare covers it without prior authorization at standard Part B cost sharing. If your pretest risk is low, asking whether a cheaper functional test would answer the question is both clinically and financially reasonable.
Questions to Ask Before Booking
- 1.Has prior authorization been approved, and did my insurer suggest a cheaper test first?
- 2.Would a stress echocardiogram or exercise ECG answer the question for me at lower cost?
- 3.What do the tracer and any stress medication add to the bill?
- 4.Is this being done in an office-based lab or a hospital department, and what is the price at each?
- 5.If the result is abnormal, what is the next test and its typical cost?
Nuclear Stress Test (CPT 78452): questions
Under 2026 Medicare rates, a nuclear stress test costs about $1,397 in total at a hospital outpatient department, counting both the physician and the facility. Outside a hospital, one global fee of about $428 covers the whole test, and a ZIP code adjusts every figure to your area.
Outside a hospital, one global fee pays for the equipment, the staff and the doctor's reading, so the office or imaging center rate for CPT 78452 is $427.87. In a hospital the physician bills only the reading, about $74.48, and the hospital is paid for the rest on its own claim.
A nuclear stress test (SPECT myocardial perfusion imaging) shows how well blood reaches your heart muscle at rest versus under stress, revealing blocked arteries. A small amount of radioactive tracer is injected, a special camera images the heart at rest, then you exercise on a treadmill or receive a medication that mimics exercise, and imaging repeats. Plan for a half day; the multiple imaging sessions and waiting periods make it one of the longest routine cardiac tests. CMS bills it as “Ht muscle image spect mult.”
It depends on the setting. At an independent imaging center, lab or office, $427.87 is Medicare's full national rate, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $74.48) and the hospital is paid separately, which takes the total to about $1,397. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.
For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.