A9572 HCPCS code: Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
A9572 is the HCPCS Level II code for indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries. In 2024 Medicare paid an average of $5,022.04 per service for A9572 across 19 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 63% from 2022 to 2024 (51 to 19 services). In 2024, about 16 clinicians billed Medicare for A9572 for 19 beneficiaries.
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 | 2008-01-01 |
| Last action effective | 2025-01-01 |
Who bills A9572 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 16 |
| Medicare beneficiaries | 19 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9572, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 51 | 49 | $5,148.71 | $4,115.64 |
| 2023 | 41 | 40 | $5,226.55 | $4,168.00 |
| 2024 | 19 | 19 | $6,300.10 | $5,022.04 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
What changed for A9572
- 2008-01-01: A9572 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 A9572?
A9572 is the HCPCS Level II code for indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries. Short descriptor: "Indium in-111 pentetreotide".
How much does Medicare pay for A9572?
In 2024, the average Medicare payment was $5,022.04 per service (average allowed $6,300.10).
Does Medicare cover A9572?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9572 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 A9572
- Watch A9572 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9572
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.