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See a sample rate comparisonHCPCS A9595 (Pylarify) 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.
Piflufolastat f-18, diagnostic, 1 millicurie
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for A9595 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS A9595 by major payers:
$575.55
$672.62
$632.18
$672.49
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HCPCS A9595
5 of 25 sample ratesHigher to lower in this preview
The Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$2,206.78Published rateUjuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$1,089.55Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$701.16Published rateChildrens National Medical Center
Childrens Hospital
$624.15Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$558.45Published rate
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See a sample payer proposalHCPCS A9595 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9595 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 A9595 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 |
|---|---|---|
| A9594-HCPCS | Moderate | Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie |
| A9595-HCPCS | Moderate | Piflufolastat f-18, diagnostic, 1 millicurie |
| A9596-HCPCS | High | Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9595 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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