Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS A9513 (Lutathera) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Lutetium lu 177, dotatate, therapeutic, 1 millicurie
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for A9513 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS A9513 by major payers:
$302.49
$339.40
$303.31
$290.92
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A9513.
HCPCS A9513
5 of 25 sample ratesHigher to lower in this preview
Northside Hospital, Inc., Northside Hospital Gwinnett
Northside Hospital Inc
$798.71Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$318.60Published rateProgressive Acute Care Avoyelles, LLC, Avoyelles Hospital
$296.25Published rateHospital Service District Of The Parish Of St. Bernard, State Of Louis, St. Bernard Parish Hospital
Hospital Service District Of The Parish Of St Bernard State Of Louis
$296.25Published rateConcordia Parish Hospital Service District Number One, Trinity Medical
Riverland Medical Center
$251.21Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS A9513 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9513 code is part of the Administrative, Miscellaneous and Investigational services used for Diagnostic and Therapeutic Radiopharmaceuticals. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS A9513 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| A9512-HCPCS | Low | Technetium Tc-99m pertechnetate, diagnostic, per millicurie |
| A9513-HCPCS | Moderate | Lutetium lu 177, dotatate, therapeutic, 1 millicurie |
| A9515-HCPCS | High | Choline c-11, diagnostic, per study dose up to 20 millicuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9513. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9513 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS A9513) and we'll show you how you compare in 15 minutes or less.