A9615 HCPCS code: Injection, pegulicianine, 1 mg
A9615 is the HCPCS Level II code for injection, pegulicianine, 1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 156 per day on outpatient hospital claims.
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 | O1E — Other drugs |
| Added | 2025-01-01 |
| Last action effective | 2025-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 156 | CMS Policy |
| practitioner claims | 156 | CMS Policy |
What changed for A9615
- 2025-01-01: A9615 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 A9615?
A9615 is the HCPCS Level II code for injection, pegulicianine, 1 mg. Short descriptor: "Inj, pegulicianine, 1 mg".
Does Medicare cover A9615?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A9615 can be billed per day?
156 on outpatient hospital claims; 156 on practitioner claims (NCCI medically unlikely edits).
Related A96 codes
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- A9607 — Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
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Next steps
- Run a reimbursement report for a device billed under A9615
- Watch A9615 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9615
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.