A9607 HCPCS code: Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
A9607 is the HCPCS Level II code for lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie. In 2024 Medicare paid an average of $203.56 per service for A9607 across 637,367 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 216 per day on outpatient hospital claims. Medicare volume rose 412% from 2022 to 2024 (124,556 to 637,367 services). In 2024, about 265 clinicians billed Medicare for A9607 for 1,073 beneficiaries; Arizona, Florida, Texas accounted for 35% 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 | 2022-10-01 |
| Last action effective | 2025-01-01 |
Who bills A9607 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 265 |
| Medicare beneficiaries | 1,073 |
| States with claims | 25 |
| Share of services in top 3 states (Arizona, Florida, Texas) | 35% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A9607, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 124,556 | 386 | $244.61 | $194.89 |
| 2023 | 592,041 | 1,019 | $248.45 | $197.94 |
| 2024 | 637,367 | 1,073 | $255.49 | $203.56 |
States with the most A9607 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Arizona | 91,106 | $203.76 |
| Florida | 70,463 | $200.59 |
| Texas | 57,950 | $210.48 |
| Maryland | 46,628 | $207.20 |
| Virginia | 42,753 | $204.83 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 216 | Prescribing Information |
| practitioner claims | 216 | Prescribing Information |
What changed for A9607
- 2022-10-01: A9607 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 A9607?
A9607 is the HCPCS Level II code for lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie. Short descriptor: "Lutetium lu 177 vipivotide".
How much does Medicare pay for A9607?
In 2024, the average Medicare payment was $203.56 per service (average allowed $255.49).
Does Medicare cover A9607?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9607 can be billed per day?
216 on outpatient hospital claims; 216 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 A9607
- Watch A9607 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9607
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.