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See a sample rate comparisonHCPCS A9521 Fee Schedule
HCPCS A9521 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
Technetium Tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | High |
| Medicaid Fee Schedule | $655.87 median of the 8 states in the free preview · View Medicaid rates for A9521 |
National average reimbursement for HCPCS A9521 by major payers:
$1,300.86
BCBS / Anthem
$1,979.89
UnitedHealthcare
$1,759.00
Aetna
$1,754.89
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A9521.
HCPCS A9521
5 of 25 sample ratesHigher to lower in this preview
The Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$5,974.00Published ratePiedmont Newnan Hospital, Inc.
Piedmont Newnan Hospital Inc
$3,063.59Published rateJasper Health Services, Inc., Jasper Memorial Hospital
Jasper Health Services Inc
$1,953.92Published rateMichael Koch
Chestatee Pathology Associates PC
$1,953.92Published ratePhoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Physician Group Inc
$1,574.22Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9521 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9521. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A9520-HCPCS | Moderate | Technetium Tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries |
| A9521-HCPCS | High | Technetium Tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries |
| A9524-HCPCS | Low | Iodine I-131 iodinated serum albumin, diagnostic, per 5 microcuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9521. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9521 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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