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HCPCS code A9500: Tc-99m sestamibi, per study dose2026 Medicare rate & RVUs

Reports an intravenous technetium-99m sestamibi dose used for diagnostic nuclear imaging, commonly myocardial perfusion studies and parathyroid localization.

CMS RVU26DEffective Oct 1, 2026109 payment localities564.6K Medicare services in 2024

Medicare rate · A9500

Tc-99m sestamibi, per study dose

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for A9500 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What A9500 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What A9500 covers

Technetium-99m sestamibi is an intravenous diagnostic radiopharmaceutical used by nuclear medicine services. A common use is myocardial perfusion imaging at rest or with stress to evaluate cardiac blood flow; it is also used in parathyroid imaging to help localize abnormal parathyroid tissue. The imaging service may use a gamma camera or SPECT, while the radiopharmaceutical is prepared and administered as part of the nuclear medicine procedure.

A9500 identifies the radiopharmaceutical by study dose. Report the quantity in study doses, rather than by milligrams or millicuries. Under physician fee schedule status C, CMS publishes no national payment amount and the Medicare Administrative Contractor sets payment for the claim; the HCPCS pricing method likewise assigns payment to the contractor. Coverage is left to the Medicare contractor’s judgment. The code is commonly associated with myocardial perfusion imaging codes such as 78451 and 78452, but those codes describe the imaging service rather than the tracer.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where A9500 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

A9500 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

A9500 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
A9500 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the A9500 rate is calculated

Each of A9500’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · A9500

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for A9500

A9500 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · A9500

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

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A9500 isn’t priced in this setting.

A9500 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • A9500

    Tc-99m sestamibi, per study dose0 wRVU

    Not priced

  • A9502

    Tetrofosmin, per study dose0 wRVU

    Not priced

  • A9505

    Thallium-201, per millicurie0 wRVU

    Not priced

  • 78451

    Cardiac SPECT, single rest or stress study1.35 wRVU

    $311.30

  • 78452

    Nuclear stress test, SPECT, multiple perfusion studies1.58 wRVU

    $427.87

How to choose

A9502TetrofosminPer study dose
A9502 is for technetium-99m tetrofosmin. Choose the code for the radiopharmaceutical actually furnished, not simply the cardiac imaging indication.
A9505Thallium-201Per millicurie
A9505 identifies thallium-201, another radiopharmaceutical used in myocardial perfusion imaging; A9500 is for technetium-99m sestamibi.
78451Cardiac SPECTSingle rest or stress study
78451 describes a single SPECT myocardial perfusion study. A9500 identifies the sestamibi dose, not the imaging service.
78452Nuclear stress testSPECT, multiple perfusion studies
78452 describes multiple SPECT myocardial perfusion studies at rest and/or stress. A9500 identifies the tracer used, not the number of imaging studies.

Codes related to A9500

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to A9500
CodeHow it relatesNational office range
Often billed with
78451Cardiac SPECT, single rest or stress studyDescribes a single-study SPECT myocardial perfusion service that may use this tracer.$272.61–$430.89
78452Nuclear stress test, SPECT, multiple perfusion studiesDescribes multiple-study SPECT myocardial perfusion imaging that may use this tracer.$373.48–$595.53
78070Parathyroid imaging, planar onlyParathyroid imaging may use sestamibi to help localize abnormal tissue.$226.83–$365.09
Used instead
A9502Tetrofosmin, per study doseIdentifies technetium-99m tetrofosmin, another tracer used for myocardial perfusion imaging.No office rate

A9500 billing questions

When should A9500 be chosen instead of A9502?

Use A9500 for technetium-99m sestamibi. A9502 identifies technetium-99m tetrofosmin, a different radiopharmaceutical that may be used for myocardial perfusion imaging.

What does one unit of A9500 represent?

One unit represents a study dose. The code is not reported by milligram or millicurie.

Which imaging services are commonly reported with A9500?

For cardiac perfusion imaging, it is commonly associated with myocardial perfusion SPECT codes such as 78451 or 78452. The imaging code describes the scan; A9500 identifies the tracer.

Can A9500 be used for parathyroid imaging?

Yes. Technetium-99m sestamibi is also used for parathyroid imaging, including localization of abnormal parathyroid tissue.

How does Medicare determine payment and coverage for A9500?

Status C means CMS publishes no national physician fee schedule payment amount; the Medicare Administrative Contractor sets payment for the claim. The contractor also determines coverage.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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