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A9572 Indium in-111 pentetreotide

What A9572 is

Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries

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

Medicare payment for A9572 (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 A9572 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: Prescribing Information. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

A9572 is bundled into these codes

A9572 appears as a Column 2 code in 25 active edits. Reported with one of these Column 1 codes on the same date of service, A9572 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0868THi-res gastric ep mapping0Check pair
38792Ra tracer id of sentinl node0Check pair
78018Thyroid met imaging body0Check pair
78102Bone marrow imaging ltd0Check pair
78104Bone marrow imaging body0Check pair
78215Lvr&spleen img static only0Check pair
78226Hepatobiliary system imaging0Check pair
78227Hepatobil syst image w/drug0Check pair
78264Gastric emptying img study0Check pair
78265Gstr emptg img sm bwl trnst0Check pair
78266Gstr empt img sm bwl&colon0Check pair
78278Acute gi blood loss imaging0Check pair
78300Bone imaging limited area0Check pair
78305Bone imaging multiple areas0Check pair
78306Bone imaging whole body1Check 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.