A9537 HCPCS code: Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
A9537 is the HCPCS Level II code for technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries. In 2024 Medicare paid an average of $34.40 per service for A9537 across 5,876 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume fell 10% from 2022 to 2024 (6,538 to 5,876 services). In 2024, about 1,071 clinicians billed Medicare for A9537 for 5,849 beneficiaries; Florida, Texas, California accounted for 38% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 57 |
| BETOS category | I1E |
| Added | 2006-01-01 |
| Last action effective | 2006-01-01 |
Who bills A9537 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,071 |
| Medicare beneficiaries | 5,849 |
| States with claims | 40 |
| Share of services in top 3 states (Florida, Texas, California) | 38% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9537, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,538 | 6,513 | $43.07 | $34.06 |
| 2023 | 6,002 | 5,974 | $43.35 | $34.35 |
| 2024 | 5,876 | 5,849 | $43.43 | $34.40 |
States with the most A9537 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 1,335 | $7.39 |
| Texas | 485 | $36.11 |
| California | 437 | $47.17 |
| New York | 365 | $41.14 |
| Maryland | 359 | $46.96 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for A9537
- 2006-01-01: A9537 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A9537?
A9537 is the HCPCS Level II code for technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries. Short descriptor: "Tc99m mebrofenin".
How much does Medicare pay for A9537?
In 2024, the average Medicare payment was $34.40 per service (average allowed $43.43).
Does Medicare cover A9537?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9537 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related A95 codes
- A9500 — Technetium tc-99m sestamibi, diagnostic, per study dose
- A9501 — Technetium tc-99m teboroxime, diagnostic, per study dose
- A9502 — Technetium tc-99m tetrofosmin, diagnostic, per study dose
- A9503 — Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries
- A9504 — Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries
- A9505 — Thallium tl-201 thallous chloride, diagnostic, per millicurie
- A9506 — Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible
- A9507 — Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
- A9508 — Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurie
- A9509 — Iodine i-123 sodium iodide, diagnostic, per millicurie
- A9510 — Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
- A9512 — Technetium tc-99m pertechnetate, diagnostic, per millicurie
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Next steps
- Run a reimbursement report for a device billed under A9537
- Watch A9537 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9537
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.