Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS A9604 (Quadramet) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
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 | 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
$18,836.03
$16,680.65
$13,079.57
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
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS A9604 vs. Other Diagnostic and Therapeutic Radiopharmaceuticals Codes
The HCPCS A9604 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 A9604 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 |
|---|---|---|
| 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS A9604) and we'll show you how you compare in 15 minutes or less.