How much does Medicare pay for HCPCS A9537?

Medicare allowed an average of $39.75 per service and paid $31.46 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $156.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code A9537?

Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries. It was billed 3,223 times to 3,219 Medicare beneficiaries by 137 providers in 2024.

Which specialty bills A9537 most?

Diagnostic Radiology, with 2,235 services from 99 clinicians. Next are Nuclear Medicine, Independent Diagnostic Testing Facility (IDTF), Internal Medicine.

HCPCS A9537

Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries

$39.75Medicare-allowed amount per service, averaged across 3,223 services

Providers submitted

$156.35

Asking price, not received

Medicare allowed

$39.75

The fee schedule figure

Medicare paid

$31.46

Balance is patient coinsurance

Providers submitted an average of $156.35 for this code and Medicare allowed $39.75 — 3.9× 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 $31.46 (79%); the rest is the patient’s coinsurance and deductible.

Services: 3,223
Beneficiaries: 3,219
Providers billing it: 137
Total allowed: $128,114

What Medicare pays for HCPCS A9537

Across 3,223 services billed by 137 providers to 3,219 beneficiaries, Medicare allowed an average of $39.75 per service. 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 A9537

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	2,235	2,234	$39.07	99
Nuclear Medicine	548	546	$38.77	15
Independent Diagnostic Testing Facility (IDTF)	270	269	$43.90	12
Internal Medicine	42	42	$58.09	3
Family Practice	42	42	$61.05	2
Interventional Radiology	34	34	$9.00	2
Pediatric Medicine	16	16	$64.28	1
Radiation Oncology	14	14	$9.00	1
Nurse Practitioner	11	11	$48.60	1
Gastroenterology	11	11	$62.05	1

A9537 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.

State	Services	Allowed	Standardized pmt	Providers
Florida	865	$9.06	$7.05	37
Texas	298	$38.15	$30.54	14
California	262	$60.66	$47.00	11
Maryland	256	$46.63	$37.34	7
New York	215	$47.88	$38.04	7
North Carolina	182	$55.09	$44.67	9
Arizona	182	$61.06	$48.62	7
Massachusetts	134	$61.79	$49.52	1
Tennessee	109	$59.68	$48.49	7
Nevada	88	$48.04	$39.79	5
Illinois	65	$24.05	$21.80	3
Nebraska	63	$61.69	$49.15	3
Mississippi	60	$33.56	$25.40	2
New Jersey	50	$89.22	$71.09	4
Missouri	47	$53.00	$42.22	2
Georgia	44	$58.75	$49.55	3
Connecticut	42	$61.84	$49.27	1
Delaware	38	$47.23	$37.63	2
Pennsylvania	37	$9.01	$6.59	1
Washington	30	$62.09	$44.45	2
South Carolina	29	$62.13	$49.50	2
Ohio	26	$9.00	$7.17	1
Colorado	25	$34.81	$27.73	1
Michigan	25	$62.05	$49.44	1
Iowa	13	$62.28	$38.03	1
Puerto Rico	13	$9.30	$7.41	1
Indiana	13	$62.13	$45.64	1
Virginia	12	$69.86	$55.66	1

Related codes

A9575Injection, gadoterate meglumine, 0.1 ml$0.12
A9585Injection, gadobutrol, 0.1 ml$0.31
A9579Injection, gadolinium-based magnetic resonance contrast agent, not oth$1.47
A9500Technetium tc-99m sestamibi$110.81
A9502Technetium tc-99m tetrofosmin$181.87
A9577Injection, gadobenate dimeglumine (multihance), per ml$1.72
A9555Rubidium rb-82$526.83
A9552Fluorodeoxyglucose f-18 fdg$321.77
A9576Injection, gadoteridol, (prohance multipack), per ml$1.46
A9595Piflufolastat f-18$626.38
A9573Injection, gadopiclenol, 1 ml$5.15
A9578Injection, gadobenate dimeglumine (multihance multipack), per ml$1.74

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.