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See a sample rate comparisonHCPCS A9537 (Technetium Tc 99m Mebrofenin) Fee Schedule
HCPCS A9537 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
Technetium Tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Low |
| Medicaid Fee Schedule | $55.49 median of the 8 states in the free preview · View Medicaid rates for A9537 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS A9537 by major payers:
$72.39
BCBS / Anthem
$66.08
UnitedHealthcare
$59.16
Aetna
$63.05
Cigna
Compare published rates across providers.
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HCPCS A9537
5 of 25 sample ratesHigher to lower in this preview
St Francis Medical Center, Inc
St Francis Medical Center Inc
$138.41Published rateErin Krupski
Slocum Dickson Medical Group PLLC
$63.06Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$63.06Published rateElizabeth Westen
Slocum Dickson Medical Group PLLC
$63.06Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$56.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9537 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9537. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A9536-HCPCS | Moderate | Technetium Tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries |
| A9537-HCPCS | Low | Technetium Tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries |
| A9538-HCPCS | Low | Technetium Tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9537. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9537 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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