HCPCS code A9557: Tc-99m bicisate, per study dose2026 Medicare rate & RVUs in Guam

Reports technetium-99m bicisate supplied for cerebral perfusion imaging, typically SPECT studies that assess patterns of blood flow in the brain.

CMS RVU26DEffective Oct 1, 20261 payment locality21 Medicare services in 2024

CMS doesn’t publish an office rate for A9557 in Guam.

—Office (non-facility)
—Hospital or facility

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 8 sections
  1. Rate in Guam
  2. What A9557 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Billing questions
  8. Sources

What A9557 covers

Technetium-99m bicisate is an intravenously administered imaging agent used for cerebral perfusion imaging, most commonly with SPECT. Nuclear medicine teams use it to show patterns of blood flow in the brain during evaluations such as suspected stroke, seizures, or cognitive disorders. The radiopharmaceutical is administered before image acquisition; the imaging service itself is distinct from the supplied dose.

Medicare assigns this code physician fee schedule status C, or carrier priced: CMS publishes no national payment, and the Medicare contractor sets payment for each claim. The HCPCS pricing method is other contractor pricing, and coverage is left to the contractor’s judgment. One unit represents a diagnostic study dose up to 25 millicuries, not a per-millicurie amount.

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.

A9557 in Hawaii, Guam, HI

A9557 office and facility rates by payment locality
Payment localityOfficeFacility
Hawaii, Guam, HIUnavailableUnavailable

How the A9557 rate is calculated

Each of A9557’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 · A9557

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 A9557

A9557 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 · A9557

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

A9557 isn’t priced in this setting.

A9557 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • A9557

    Tc-99m bicisate, per study dose0 wRVU

    Not priced

  • A9552

    FDG, per study dose0 wRVU

    Not priced

  • A9550

    Tc-99m gluceptate, per study dose0 wRVU

    Not priced

  • A9556

    Gallium-67 citrate, per millicurie0 wRVU

    Not priced

How to choose

A9552FDGPer study dose
A9552 identifies fluorodeoxyglucose used for PET imaging. A9557 identifies technetium-99m bicisate used for cerebral perfusion imaging, typically SPECT.
A9550Tc-99m gluceptatePer study dose
A9550 identifies technetium-99m gluceptate, a different radiopharmaceutical. Select the code for the agent supplied; it is not interchangeable with bicisate.
A9556Gallium-67 citratePer millicurie
A9556 identifies gallium-67, not technetium-99m bicisate. The codes represent different radiopharmaceuticals and are selected according to the agent used.

A9557 billing questions

What does one unit represent?

One unit represents a diagnostic study dose of technetium-99m bicisate, up to 25 millicuries. It is not a unit for each millicurie.

Is this the code for brain SPECT imaging?

No. It identifies the bicisate radiopharmaceutical dose used in cerebral perfusion imaging, not the image acquisition.

How does Medicare price this code?

It has physician fee schedule status C: CMS publishes no national payment, and the Medicare contractor sets payment for the claim. The HCPCS pricing method is other contractor pricing.

Does Medicare cover every bicisate study?

Coverage is left to the Medicare contractor’s judgment.

Should this be selected for a PET brain study?

No. Bicisate is used for cerebral perfusion imaging, typically SPECT. A PET study uses a different imaging approach and may use a different radiopharmaceutical, such as FDG.

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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