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A9543 Y90 ibritumomab, rx

What A9543 is

Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries

HCPCS Level II long description, CMS October 2026 file. See the A codes page for the full section.

Medicare payment for A9543 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps A9543 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

A9543 is bundled into these codes

A9543 appears as a Column 2 code in 7 active edits. Reported with one of these Column 1 codes on the same date of service, A9543 is the code that denies.

Column 1 codeShort descriptionModifier indicator
78195Lymph system imaging0Check pair
78201Liver imaging static only0Check pair
78215Lvr&spleen img static only1Check pair
78800Rp loclzj tum 1 area 1 d img1Check pair
78802Rp loclzj tum whbdy 1 d img1Check pair
78803Rp loclzj tum spect 1 area1Check pair
78804Rp loclzj tum whbdy 2+d img1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.