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HCPCS code A9516: Iodine-123 sodium iodide, per 100 microcuries2026 Medicare rate & RVUs

Reports diagnostic iodine-123 sodium iodide used for thyroid uptake measurement or imaging, in units representing 100 microcuries each.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.3K Medicare services in 2024

Medicare rate · A9516

Iodine-123 sodium iodide, per 100 microcuries

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 A9516 →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 A9516 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 A9516 covers

Iodine-123 sodium iodide is a diagnostic radiopharmaceutical taken up by thyroid tissue. Nuclear medicine teams typically administer it orally before measuring thyroid uptake or obtaining thyroid images, such as during evaluation of thyroid function or anatomy. The radiopharmaceutical supply is distinct from the uptake measurement or imaging service performed and interpreted by the nuclear medicine team.

Medicare assigns this HCPCS Level II code carrier-priced status: CMS publishes no national physician fee schedule payment, and the Medicare contractor sets payment for the claim. CMS classifies its pricing as other contractor pricing and leaves coverage to the contractor’s judgment. One unit represents 100 microcuries; report units based on the administered activity, subject to the code’s limit of 999 microcuries. For example, 300 microcuries is 3 units.

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 A9516 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

A9516 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

A9516 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
A9516 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 A9516 rate is calculated

Each of A9516’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 · A9516

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 A9516

A9516 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 · A9516

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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A9516 isn’t priced in this setting.

A9516 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • A9516

    Iodine-123 sodium iodide, per 100 microcuries0 wRVU

    Not priced

  • A9509

    Iodine I-123, per millicurie0 wRVU

    Not priced

  • A9528

    Iodine-131 capsule, diagnostic, per millicurie0 wRVU

    Not priced

  • A9517

    I-131 capsule, therapeutic, per millicurie0 wRVU

    Not priced

How to choose

A9509Iodine I-123Per millicurie
A9509 is another code for diagnostic iodine-123 sodium iodide, but uses a different dose basis. Select between the codes according to the dose and applicable code unit.
A9528Iodine-131 capsuleDiagnostic, per millicurie
A9528 identifies diagnostic iodine-131 iodide, not iodine-123 sodium iodide. The radionuclide and radiopharmaceutical are different.
A9517I-131 capsuleTherapeutic, per millicurie
A9517 identifies therapeutic iodine-131 iodide. A9516 is for diagnostic iodine-123 sodium iodide, not radioiodine therapy.

Codes related to A9516

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

Codes related to A9516
CodeHow it relatesNational office range
Same family
A9509Iodine I-123, per millicurieDiagnostic iodine-123 sodium iodide reported using a different dose basis.No office rate
Often billed with
78012Thyroid uptake, uptake measurement onlyThyroid uptake measurement service that may be performed with this radiopharmaceutical.$69.29–$112.28
78013Thyroid imaging, with blood-flow imagingThyroid imaging service that may use this diagnostic radiopharmaceutical.$143.72–$233.87
78014Thyroid scan, quantitative uptake measurementThyroid imaging with uptake measurement using a diagnostic radiopharmaceutical.$182.55–$296.36

A9516 billing questions

How many units should be reported?

Each unit represents 100 microcuries. Report the administered activity in 100-microcurie units; 300 microcuries equals 3 units.

When should A9516 be chosen over A9509?

Both codes identify diagnostic iodine-123 sodium iodide, but A9516 is the per-100-microcurie code for doses up to 999 microcuries. Use the code whose dose basis matches the radiopharmaceutical amount.

Does A9516 describe the thyroid imaging service?

No. A9516 identifies the radiopharmaceutical supply. Thyroid uptake measurement or imaging is represented by its own service code when performed.

How does Medicare price and cover A9516?

It is carrier priced, with no national physician fee schedule payment; the Medicare contractor sets payment for the claim. Coverage is left to the contractor’s judgment.

What should the record support?

Document the iodine-123 sodium iodide administered and its activity in microcuries so the billed units can be tied to the dose.

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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