A9576 HCPCS code: Injection, gadoteridol, (prohance multipack), per ml
A9576 is the HCPCS Level II code for injection, gadoteridol, (prohance multipack), per ml. In 2024 Medicare paid an average of $1.14 per service for A9576 across 279,998 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 100 per day on outpatient hospital claims. Medicare volume fell 2% from 2022 to 2024 (286,282 to 279,998 services). In 2024, about 860 clinicians billed Medicare for A9576 for 17,612 beneficiaries; New York, Virginia, Florida accounted for 48% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | I1E |
| Added | 2008-01-01 |
| Last action effective | 2008-01-01 |
Who bills A9576 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 860 |
| Medicare beneficiaries | 17,612 |
| States with claims | 35 |
| Share of services in top 3 states (New York, Virginia, Florida) | 48% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9576, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 286,282 | 18,511 | $1.42 | $1.11 |
| 2023 | 312,318 | 19,960 | $1.40 | $1.10 |
| 2024 | 279,998 | 17,612 | $1.46 | $1.14 |
States with the most A9576 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 51,435 | $1.16 |
| Virginia | 46,842 | $1.09 |
| Florida | 35,194 | $1.17 |
| Colorado | 30,627 | $1.16 |
| California | 17,284 | $1.13 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 100 | Prescribing Information |
| practitioner claims | 100 | Prescribing Information |
What changed for A9576
- 2008-01-01: A9576 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 A9576?
A9576 is the HCPCS Level II code for injection, gadoteridol, (prohance multipack), per ml. Short descriptor: "Inj prohance multipack".
How much does Medicare pay for A9576?
In 2024, the average Medicare payment was $1.14 per service (average allowed $1.46).
Does Medicare cover A9576?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9576 can be billed per day?
100 on outpatient hospital claims; 100 on practitioner claims (NCCI medically unlikely edits).
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Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A9576
- Watch A9576 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9576
Sources: CMS HCPCS Level II release October 2026; 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.