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See a sample rate comparisonHCPCS A9540 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.
Technetium Tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A9540 |
National average reimbursement for HCPCS A9540 by major payers:
$47.84
$34.79
$38.14
$32.91
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HCPCS A9540
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$75.24Published rateAugusta Vamc
$34.20Published rateThomas Kaelin
Lowcountry Lung Critical Care PA
$34.20Published rateDavid Handshoe
Lowcountry Lung Critical Care PA
$28.04Published rateKayla Hanks
Lowcountry Lung Critical Care PA
$28.04Published rate
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See a sample payer proposalHCPCS A9540 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9540 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 A9540 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 |
|---|---|---|
| A9539-HCPCS | Low | Technetium Tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries |
| A9540-HCPCS | Low | Technetium Tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries |
| A9541-HCPCS | Moderate | Technetium Tc-99m sulfur colloid, 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 A9540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9540 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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