HCPCS code A9528: Iodine-131 capsule, diagnostic, per millicurie2026 Medicare rate & RVUs in Texas
Oral diagnostic iodine-131 sodium iodide supplied for thyroid uptake or imaging studies, reported according to the millicuries furnished.
CMS doesn’t publish an office rate for A9528 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What A9528 covers
This code identifies radioactive sodium iodide in capsule form for diagnostic use. Nuclear medicine teams use oral iodine-131 in thyroid uptake and imaging evaluations, including assessment of thyroid function or thyroid tissue. A nuclear medicine physician typically interprets the study, while the radiopharmaceutical may be supplied by a radiopharmacy and administered in a nuclear medicine setting. The capsule is the radiopharmaceutical, not the imaging or uptake procedure itself.
The HCPCS unit is one millicurie, so report the number of millicuries furnished. The physician fee schedule status is C, carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim under other contractor pricing. Coverage is left to the Medicare contractor’s judgment.
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 A9528 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
How the A9528 rate is calculated
Each of A9528’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 · A9528
RVUs × geographic indexes × conversion factor
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 A9528
A9528 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 · A9528
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
—
A9528 isn’t priced in this setting.
A9528 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- A9529I-131 sodium iodideDiagnostic solution, per mCi
- Both identify diagnostic iodine-131 sodium iodide, but A9528 is the capsule and A9529 is the solution.
- A9516Iodine-123 sodium iodidePer 100 microcuries
- A9516 is diagnostic iodine-123 sodium iodide. Choose by the radiopharmaceutical and isotope furnished, not simply because both are used for thyroid studies.
- A9517I-131 capsuleTherapeutic, per millicurie
- A9517 identifies iodine-131 capsules for therapeutic use; A9528 is for diagnostic use.
- 78014Thyroid scanQuantitative uptake measurement
- 78014 reports thyroid imaging with uptake, while A9528 reports the diagnostic iodine-131 capsule supplied for the study.
A9528 billing questions
How many units should be reported?
Report one unit for each millicurie of iodine-131 sodium iodide furnished. The code is based on the activity supplied, not the number of capsules.
When should this be chosen over A9529?
A9528 is for diagnostic iodine-131 sodium iodide in capsule form. A9529 identifies the diagnostic solution form.
Is this the code for therapeutic iodine-131?
No. A9528 identifies diagnostic capsules. A9517 is the related iodine-131 capsule code for therapeutic use.
Does A9528 include the thyroid imaging procedure?
No. A9528 represents the radiopharmaceutical. The performed thyroid uptake or imaging service is reported with its applicable procedure code.
How does Medicare set payment and coverage?
The physician fee schedule status is C, or carrier priced, and the Medicare Administrative Contractor sets payment for each claim. Coverage is left to that contractor’s judgment.
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
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