A9554 I125 iothalamate, dx
What A9554 is
Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries
HCPCS Level II long description, CMS October 2026 file. See the A codes page for the full section.
Medicare payment for A9554 (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.
Medically Unlikely Edit (MUE)
Medicare caps A9554 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.
A9554 is bundled into these codes
A9554 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, A9554 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
78122 | Whl bld volume determination | 0 | Check pair |
78428 | Cardiac shunt imaging | 0 | Check pair |
78452 | Ht muscle image spect mult | 0 | Check pair |
78582 | Lung ventilat&perfus imaging | 0 | Check pair |
78707 | K flow/funct image w/o drug | 0 | Check 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.