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See a sample rate comparisonHCPCS A9513 (Lutathera) Fee Schedule
HCPCS A9513 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
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| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $341.08 median of the 8 states in the free preview · 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
BCBS / Anthem
$339.40
UnitedHealthcare
$303.31
Aetna
$290.92
Cigna
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
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9513 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9513. Select one to see its fee schedule.
| 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.
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