HCPCS A9555

Across 336,870 services billed by 1,597 providers to 205,957 beneficiaries, Medicare allowed an average of $526.83 per service. That is 1.6 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.

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.

• 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
• 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
• A9587Gallium ga-68$84.81

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.

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