How much does Medicare pay for HCPCS Q9969?

Medicare allowed an average of $14.28 per service and paid $11.38 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $36.97, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q9969?

Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose. It was billed 9,893 times to 6,195 Medicare beneficiaries by 105 providers in 2024.

Which specialty bills Q9969 most?

Cardiology, with 7,852 services from 76 clinicians. Next are Interventional Cardiology, Diagnostic Radiology, Clinical Cardiac Electrophysiology.

HCPCS Q9969

Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose

$14.28Medicare-allowed amount per service, averaged across 9,893 services

Providers submitted

$36.97

Asking price, not received

Medicare allowed

$14.28

The fee schedule figure

Medicare paid

$11.38

Balance is patient coinsurance

Providers submitted an average of $36.97 for this code and Medicare allowed $14.28 — 2.6× 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 $11.38 (80%); the rest is the patient’s coinsurance and deductible.

Services: 9,893
Beneficiaries: 6,195
Providers billing it: 105
Total allowed: $141,272

What Medicare pays for HCPCS Q9969

Across 9,893 services billed by 105 providers to 6,195 beneficiaries, Medicare allowed an average of $14.28 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.

Who bills Q9969

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	7,852	4,703	$14.60	76
Interventional Cardiology	905	548	$17.17	15
Diagnostic Radiology	766	748	$9.87	8
Clinical Cardiac Electrophysiology	145	74	$9.84	1
Family Practice	138	69	$9.63	1
Internal Medicine	66	42	$9.84	3
Hospitalist	21	11	$8.90	1

Q9969 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
North Carolina	2,669	$9.77	$7.82	36
Alabama	1,343	$9.64	$7.83	11
Massachusetts	1,319	$15.01	$11.98	9
California	1,102	$11.60	$9.24	8
Illinois	918	$47.17	$37.76	6
Washington	680	$9.77	$7.86	15
Georgia	552	$9.78	$7.80	4
Arizona	305	$9.77	$7.86	3
Virginia	305	$9.66	$7.89	3
Tennessee	204	$9.65	$7.94	2
District of Columbia	197	$14.76	$11.76	1
Ohio	141	$12.65	$10.19	1
Texas	46	$11.98	$9.54	2
Maine	41	$9.84	$7.84	1
New York	34	$9.84	$7.84	1
Kentucky	19	$15.81	$12.59	1
Rhode Island	18	$9.84	$7.84	1

Related codes

Q9967Low osmolar contrast material$0.13
Q9966Low osmolar contrast material$0.36
Q9965Low osmolar contrast material$1.37
Q9957Injection, perflutren lipid microspheres, per ml$41.40
Q9958High osmolar contrast material$0.08
Q9968Injection, non-radioactive, non-contrast, visualization adjunct (e.g.,$7.59
Q9956Injection, octafluoropropane microspheres, per ml$41.27
Q9950Injection, sulfur hexafluoride lipid microspheres, per ml$18.49
Q9961High osmolar contrast material$0.28
Q9983Florbetaben f18$3080.60
Q9963High osmolar contrast material$0.21
Q9982Flutemetamol f18$3525.03

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.