RxDoctor Payments Data

HCPCS A9607

Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie

$255.39Medicare-allowed amount per service, averaged across 301,011 services
Providers submitted
$511.81

Asking price, not received

Medicare allowed
$255.39

The fee schedule figure

Medicare paid
$203.49

Balance is patient coinsurance

Providers submitted an average of $511.81 for this code and Medicare allowed $255.392.0× 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 $203.49 (80%); the rest is the patient’s coinsurance and deductible.

Services
301,011

Medicare Part B, 2024

Beneficiaries
592
Providers billing it
31
Total allowed
$76,875,199

Services × allowed amount

What Medicare pays for HCPCS A9607

Across 301,011 services billed by 31 providers to 592 beneficiaries, Medicare allowed an average of $255.39 per service. That is 508.5 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 A9607

SpecialtyServicesBeneficiariesAvg allowedProviders
Radiation Oncology115,886213$256.7612
Nuclear Medicine112,322219$251.7510
Diagnostic Radiology64,639146$259.058
Medical Oncology8,16414$257.061

A9607 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
Arizona65,792$254.45$204.928
Virginia35,683$256.86$204.653
Maryland30,425$261.57$208.391
Pennsylvania30,161$252.31$200.981
Texas29,450$261.54$208.333
Florida25,717$251.80$200.604
California15,580$244.11$194.482
Michigan15,200$253.62$203.981
Washington14,410$256.05$203.963
New Jersey13,571$253.75$209.621
Georgia8,164$257.06$204.811
Nebraska6,995$254.95$203.051
New Mexico6,059$259.48$206.721
North Carolina3,804$256.83$204.631

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.