HCPCS code A9540: Tc-99m MAA, per study dose2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for A9540 in California.

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

What A9540 covers

Technetium-99m macroaggregated albumin (MAA) is injected intravenously for lung perfusion imaging. Its particles temporarily lodge in the pulmonary capillary bed, allowing nuclear medicine imaging to show the distribution of blood flow through the lungs. Nuclear medicine departments and imaging centers typically report the radiopharmaceutical for a perfusion study, including the perfusion portion of a ventilation-perfusion examination. The imaging service itself is reported separately when performed; this code identifies the MAA dose, not the imaging procedure.

Medicare assigns this HCPCS Level II code carrier-priced status C on the physician fee schedule: CMS publishes no national payment amount, and the Medicare Administrative Contractor sets payment for the claim. The HCPCS pricing method likewise assigns payment setting to the Medicare contractor, and coverage is left to that contractor’s judgment. The code represents one study dose of up to 10 millicuries. For a combined ventilation-perfusion study, the inhaled ventilation agent is distinct from the intravenous MAA perfusion dose.

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 A9540 pays more and less in California

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

29 of 29 payment localities

How the A9540 rate is calculated

Each of A9540’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.

Payment rules and modifiers for A9540

A9540 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.

A9540 compared with similar codes

How to choose

A9539Tc-99m pentetatePer study dose

A9540 is the intravenous MAA dose for lung perfusion. A9539 identifies technetium-99m pentetate used for the ventilation portion of a combined study.

78580Lung perfusion scanPerfusion only

78580 reports the lung perfusion imaging service; A9540 identifies the MAA radiopharmaceutical dose used for that service.

Codes related to A9540

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

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