Nuclear Medicine and Charging for Radiopharmaceuticals
Radiopharmaceuticals
The hospital charge master should contain specific charges for all radiopharmaceuticals that are used in conjunction with Nuclear Medicine procedures.
The table below presents the HCPCS Level II for radiopharmaceuticals. The status indicator and the applicable UB-04 revenue codes are also included. The status indicator is part of OPPS and represents whether payment is by APC, by fee schedule, or not paid. The UB-04 revenue code is a four digit number that describes the type of service provided, e.g. 0343 Nuclear Medicine — Diagnostic Radiopharmaceutical, or 0344 Nuclear Medicine — Therapeutic Radiopharmaceutical.
For the table below:
** Status Indicator N means that this is an incidental service and not separately paid under OPPS.
** Status Indicator K means that this is a paid under OPPS
** Status Indicator U means that this is paid under OPPS
| HCPCS Code | Description | Status Indicator | Revenue Code |
| A4641 | Radiopharmaceutical, diagnostic, not otherwise classified | N | 0343 |
| A4642 | Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries | N | 0343 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | N | 0343 |
| A9501 | Technetium tc-99m teboroxime, diagnostic, per study dose | N | 0343 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | N | 0343 |
| A9503 | Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries | N | 0343 |
| A9504 | Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries | N | 0343 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | N | 0343 |
| A9507 | Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries | N | 0343 |
| A9508 | Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie | N | 0343 |
| A9509 | Iodine i-123 sodium iodide, diagnostic, per millicurie | N | 0343 |
| A9510 | Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries | N | 0343 |
| A9512 | Technetium tc-99m pertechnetate, diagnostic, per millicurie | N | 0343 |
| A9515 | Choline c-11, diagnostic, per study dose up to 20 millicuries | N | 0343 |
| A9516 | Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries | N | 0343 |
| A9520 | Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries | N | 0343 |
| A9521 | Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries | N | 0343 |
| A9524 | Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries | N | 0343 |
| A9526 | Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries | N | 0343 |
| A9528 | Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie | N | 0343 |
| A9529 | Iodine i-131 sodium iodide solution, diagnostic, per millicurie | N | 0343 |
| A9531 | Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries) | N | 0343 |
| A9532 | Iodine i-125 serum albumin, diagnostic, per 5 microcuries | N | 0343 |
| A9536 | Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries | N | 0343 |
| A9537 | Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries | N | 0343 |
| A9538 | Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries | N | 0343 |
| A9539 | Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries | N | 0343 |
| A9540 | Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries | N | 0343 |
| A9541 | Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries | N | 0343 |
| A9542 | Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries | N | 0343 |
| A9546 | Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurie | N | 0343 |
| A9547 | Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurie | N | 0343 |
| A9548 | Indium in-111 pentetate, diagnostic, per 0.5 millicurie | N | 0343 |
| A9550 | Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie | N | 0343 |
| A9551 | Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries | N | 0343 |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | N | 0343 |
| A9553 | Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries | N | 0343 |
| A9554 | Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries | N | 0343 |
| A9555 | Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries | N | 0343 |
| A9556 | Gallium ga-67 citrate, diagnostic, per millicurie | N | 0343 |
| A9557 | Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries | N | 0343 |
| A9558 | Xenon xe-133 gas, diagnostic, per 10 millicuries | N | 0343 |
| A9559 | Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie | N | 0343 |
| A9560 | Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries | N | 0343 |
| A9561 | Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries | N | 0343 |
| A9562 | Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries | N | 0343 |
| A9566 | Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries | N | 0343 |
| A9567 | Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries | N | 0343 |
| A9568 | Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries | N | 0343 |
| A9569 | Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose | N | 0343 |
| A9570 | Indium in-111 labeled autologous white blood cells, diagnostic, per study dose | N | 0343 |
| A9571 | Indium in-111 labeled autologous platelets, diagnostic, per study dose | N | 0343 |
| A9572 | Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries | N | 0343 |
| A9580 | Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries | N | 0343 |
| A9582 | Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries | N | 0343 |
| A9584 | Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries | N | 0343 |
| A9586 | Florbetapir f18, diagnostic, per study dose, up to 10 millicuries | N | 0343 |
| A9587 | Gallium ga-68, dotatate, diagnostic, 0.1 millicurie | N | 0343 |
| A9588 | Fluciclovine f-18, diagnostic, 1 millicurie | N | 0343 |
| A9597 | Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified | N | 0343 |
| A9598 | Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified | N | 0343 |
| Q9982 | Flutemetamol f18, diagnostic, per study dose, up to 5 millicuries | N | 0343 |
| Q9983 | Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuries | N | 0343 |
| C9898 | Radiolabeled product provided during a hospital inpatient stay | N | 0343 or 0344 |
| A9517 | Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie | K | 0344 |
| A9530 | Iodine i-131 sodium iodide solution, therapeutic, per millicurie | K | 0344 |
| A9543 | Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries | K | 0344 |
| A9563 | Sodium phosphate p-32, therapeutic, per millicurie | K | 0344 |
| A9600 | Strontium sr-89 chloride, therapeutic, per millicurie | K | 0344 |
| A9604 | Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries | K | 0344 |
| A9606 | Radium ra-223 dichloride, therapeutic, per microcurie | K | 0344 |
| A9699 | Radiopharmaceutical, therapeutic, not otherwise classified | N | 0344 |
| A9527 | Iodine i-125, sodium iodide solution, therapeutic, per millicurie | U | 0344 |