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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for A9552 |
National average reimbursement for HCPCS A9552 by major payers:

$363.33

$364.63

$350.92

$672.11
Choose a payer to see a sample of rates for HCPCS A9552.
Healtheast St Johns Hospital
Community Physicians Of Indiana Inc
Goshen Health System Inc
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalHCPCS A9552 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9552 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 A9552 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 |
|---|---|---|
| A9551-HCPCS | Moderate | Technetium Tc-99m succimer, diagnostic, per study dose, up to 10 millicuries |
| A9552-HCPCS | Moderate | Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 millicuries |
| A9553-HCPCS | Moderate | Chromium Cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9552 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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