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See a sample rate comparisonHCPCS A9504 Fee Schedule
HCPCS A9504 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
Technetium Tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $400.00 median of the 7 states in the free preview · View Medicaid rates for A9504 |
National average reimbursement for HCPCS A9504 by major payers:
$388.67
BCBS / Anthem
$507.00
UnitedHealthcare
$427.32
Aetna
$456.67
Cigna
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HCPCS A9504
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,100.00Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$500.00Published rateKamran Rajaee
$500.00Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
$500.00Published rateEmory Crawford Long Hospital
Emory University
$435.64Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9504 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9504. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A9503-HCPCS | Low | Technetium Tc-99m medronate, diagnostic, per study dose, up to 30 millicuries |
| A9504-HCPCS | Moderate | Technetium Tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries |
| A9505-HCPCS | Low | Thallium Tl-201 thallous chloride, diagnostic, per millicurie |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9504. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9504 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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