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See a sample rate comparisonHCPCS A9604 (Quadramet) Fee Schedule
HCPCS A9604 is classified under Administrative, Miscellaneous and Investigational, in the Diagnostic and Therapeutic Radiopharmaceuticals subgroup.
Samarium Sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
| Key Fact | Detail |
|---|---|
| Service Type | Administrative, Miscellaneous and Investigational Diagnostic and Therapeutic Radiopharmaceuticals |
| Complexity Level | High |
| Medicaid Fee Schedule | $17,300.24 median of the 6 states in the free preview · View Medicaid rates for A9604 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS A9604 by major payers:
$14,147.47
BCBS / Anthem
$18,836.03
UnitedHealthcare
$16,680.65
Aetna
$13,079.57
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A9604.
HCPCS A9604
5 of 25 sample ratesHigher to lower in this preview
Fred Hutchinson Cancer Center
$45,738.60Published rateFayette Community Hospital, Inc., Piedmont Fayette Hospital
Fayette Community Hospital Inc
$33,656.71Published rateHospital Authority Of Liberty County, Liberty Regional Medical Center
$18,562.49Published rateStephens County Anesthesia Services,LLC
Stephens County Anesthesia Servicesllc
$18,562.49Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$16,608.54Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A9604 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The table lists codes related to A9604. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A9602-HCPCS | Moderate | Fluorodopa f-18, diagnostic, per millicurie |
| A9604-HCPCS | High | Samarium Sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries |
| A9606-HCPCS | Low | Radium Ra-223 dichloride, therapeutic, per microcurie |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A9604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A9604 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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