CPT
70450 — CT scan of head/brain without contrast
Same scan can cost 5x more at a hospital than at an imaging center.
Imaging
78452 — Myocardial perfusion imaging, tomographic ; multiple studies
A nuclear stress test (SPECT) that involves injecting a small amount of radioactive tracer and taking multiple specialized heart images to show how well blood flows to the heart muscle at rest and during stress.
- Typical setting: Hospital, nuclear medicine center
- National avg charge (illustrative): $450–$1,100 Medicare allowed (includes facility/professional); $600–$2,500 commercial; varies by region
- Most-disputed reason: Billing 78452 (multiple studies, i.e., rest and stress) when only a single-phase study was performed — single study requires 78451
What it means
What 78452 actually means
A nuclear stress test (SPECT) that involves injecting a small amount of radioactive tracer and taking multiple specialized heart images to show how well blood flows to the heart muscle at rest and during stress. It is used to diagnose coronary artery disease and evaluate patients with chest pain.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 78452 (multiple studies, i.e., rest and stress) when only a single-phase study was performed — single study requires 78451
- Billing 78452 alongside separate stress testing codes (93015–93018) without verifying bundling rules — the nuclear stress test and treadmill/pharmacologic stress may need to be billed with specific modifiers or as bundled
- Separate billing of the radiopharmaceutical tracer (A9500 or A9502) — these are often separately billable HCPCS codes but payer policies vary widely
If you see 78452 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 78452 often also see these adjacent codes on the same bill.
CPT
70470 — CT head/brain with and without contrast
If contrast wasn't given, 70470 is the wrong code.
CPT
70486 — CT maxillofacial area; without contrast material
Imaging — verify professional + technical components weren't double-billed.
CPT
70551 — MRI brain without contrast
Same scan can be 5x cheaper at a freestanding imaging center.
CPT
71045 — Chest X-ray, single view
Same image can cost 10x more at a hospital than a freestanding imaging center.
CPT
71046 — Chest X-ray, two views (PA + lateral)
Two-view CXR is standard. Watch the price gap between hospital and freestanding.
Related BillBusted guides
Plain-English reads if you see 78452 on a bill.
78452 FAQ
Plain-English answers.
What does 78452 usually cost?
$450–$1,100 Medicare allowed (includes facility/professional); $600–$2,500 commercial; varies by region. Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 78452?
Billing 78452 (multiple studies, i.e., rest and stress) when only a single-phase study was performed — single study requires 78451
What should I do if I see 78452 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 78452 before paying.
Don't pay 78452 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.