RxDoctor Payments Data

HCPCS A9500

Technetium tc-99m sestamibi, diagnostic, per study dose

$110.81Medicare-allowed amount per service, averaged across 546,847 services
Providers submitted
$376.44

Asking price, not received

Medicare allowed
$110.81

The fee schedule figure

Medicare paid
$87.98

Balance is patient coinsurance

Providers submitted an average of $376.44 for this code and Medicare allowed $110.813.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $87.98 (79%); the rest is the patient’s coinsurance and deductible.

Services
546,847

Medicare Part B, 2024

Beneficiaries
313,627
Providers billing it
3,972
Total allowed
$60,596,116

Services × allowed amount

What Medicare pays for HCPCS A9500

Across 546,847 services billed by 3,972 providers to 313,627 beneficiaries, Medicare allowed an average of $110.81 per service. That is 1.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills A9500

SpecialtyServicesBeneficiariesAvg allowedProviders
Cardiology418,611240,426$113.102,845
Interventional Cardiology83,34546,703$99.56606
Internal Medicine17,54910,403$111.20174
Clinical Cardiac Electrophysiology6,7073,778$115.4165
Diagnostic Radiology6,3154,062$124.12112
Nuclear Medicine6,0783,564$79.8042
Family Practice2,5151,427$113.6559
Independent Diagnostic Testing Facility (IDTF)2,2631,319$117.2817
Advanced Heart Failure and Transplant Cardiology834460$100.5812
Physician Assistant563291$92.943
Nurse Practitioner438227$95.1312
Pediatric Medicine364186$114.012
Hospitalist252144$321.163
Peripheral Vascular Disease212106$102.884
Gastroenterology13367$125.021

A9500 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Florida98,609$121.00$95.19595
California74,424$91.04$72.65410
New York62,639$116.29$91.33362
Arizona31,425$77.05$61.75169
Texas27,547$117.89$94.39412
North Carolina24,611$106.11$84.36195
New Jersey18,343$167.71$133.36203
South Carolina17,616$108.46$84.91105
Michigan17,395$120.22$95.26119
Illinois16,936$122.23$97.8690
Massachusetts12,907$124.72$98.3981
Virginia12,127$110.26$87.7179
Nevada11,430$53.36$43.2472
Maryland10,972$154.70$123.83113
Ohio10,585$42.04$33.5272
Alabama10,226$107.32$86.2582
Georgia8,933$108.56$86.8860
Connecticut7,376$114.07$88.3172
Louisiana6,693$102.02$81.7986
Tennessee6,385$110.76$87.2838
Pennsylvania4,968$140.54$111.7982
Indiana4,798$125.53$100.9732
Kansas4,536$122.85$99.0521
Iowa4,253$121.35$97.0236
West Virginia4,184$107.66$86.1013
Missouri3,756$122.42$98.1542
Nebraska3,511$119.07$95.1916
Delaware3,426$111.23$89.4928
Wisconsin3,262$102.31$80.9631
Kentucky2,473$118.49$93.2613
Washington2,051$49.78$39.9135
Arkansas1,890$137.34$111.0521
Wyoming1,833$161.83$130.888
Rhode Island1,710$124.85$98.3613
Alaska1,514$113.68$92.1514
Oregon1,465$72.15$57.8813
Mississippi1,417$127.30$102.0322
Oklahoma1,090$98.58$80.3611
Utah1,075$117.93$94.6013
Minnesota1,018$126.79$95.2126
Guam964$234.56$202.421
Colorado851$154.15$123.7127
Idaho845$109.54$87.093
Puerto Rico779$118.82$95.5510
District of Columbia695$123.52$98.8210
Hawaii474$101.18$82.284
New Mexico281$219.32$173.083
Montana133$39.17$31.212
North Dakota126$46.41$36.972
Vermont116$119.08$94.622
Maine106$32.13$27.682
New Hampshire68$118.65$101.231

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.