HCPCS A9553 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Administrative, Miscellaneous and Investigational • Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
National average reimbursement for HCPCS A9553 by major payers:
$318.44
$686.70
$398.12
$362.57
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A9553 | ||||||
United | A9553 | $824.32 | 1982600540 - UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC., PIEDMONT MCDUFFIE HOSPITAL | 454166209 - (GA) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $690.40 | 1710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.79 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | A9553 | $676.79 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.79 | 1033435664 - SMITH OF GEORGIA, SMITH NORTHVIEW HOSPITALISTS | 271652335 - (GA) SMITH OF GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.80 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | A9553 | $676.79 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTY | GA | Rural Acute Care Hospital (282NR1301X) |
United | A9553 | $676.79 | 1518912666 - STEPHENS COUNTY ANESTHESIA SERVICES,LLC | 300429607 - (GA) STEPHENS COUNTY ANESTHESIA SERVICESLLC | GA | Rural Acute Care Hospital (282NR1301X) |
United | A9553 | $824.32 | 1134133002 - PIEDMONT NEWNAN HOSPITAL, INC. | 205077249 - (GA) PIEDMONT NEWNAN HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.79 | 1508900101 - MICHAEL KOCH | 30450086 - (GA) CHESTATEE PATHOLOGY ASSOCIATES PC | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.79 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | A9553 | $676.79 | 1245248624 - HOSPITAL AUTHORITY OF BEN HILL, DORMINY MEDICAL CENTER | 581157005 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A9553 | $1543.09 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A9553 | $676.79 | 1710105119 - THE HOSPITAL AUTHORITY OF MILLER COUNTY, MILLER COUNTY HOSPITAL - PRO FEES | 586010601 - THE HOSPITAL AUTHORITY OF MILLER COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | A9553 | $676.79 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A9553 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9553 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 A9553 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 |
|---|---|---|
| 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 |
| A9554-HCPCS | Moderate | Iodine I-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9553 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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