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HCPCS A4641 · Level II · A code

A4641: Radiopharmaceutical, diagnostic, not otherwise classified, HCPCS Level II A code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for A4641

Medicare payment
no PFS amount
PFS status C
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
MUE
none published
no MUE in the 2026 Q4 tables
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
12
12 hospital outpatient
LCDs and articles
1 / 3

TL;DR

A4641 is a Level II code from the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), in use since 1994: "Radiopharmaceutical, diagnostic, not otherwise classified". The physician fee schedule lists A4641 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it. In the NCCI PTP files v323r0 A4641 appears in 12 practitioner pairs as column 2 and 0 as column 1 (most often with 78432, 78433, 78459), and in 12 hospital outpatient pairs as column 2 and 0 as column 1. 1 active LCD and 3 billing and coding articles list A4641 across 6 states: L33457 (Cardiac Radionuclide Imaging), A52437, A54880. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS I1E (standard imaging - nuclear medicine); pricing indicator 51; type of service 4 (diagnostic radiology). 1 other active code opens with "Radiopharmaceutical"; related codes: A9699, A4649, A4630, A4615.

A4641 descriptor and code status

The October 2026 HCPCS Level II file describes A4641 as “Radiopharmaceutical, diagnostic, not otherwise classified”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes. Although searches often call it the "A4641 CPT code", A4641 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of A4641
FieldValue
Short descriptorRadiopharm dx agent noc
Added to HCPCS1994-01-01
Last actionN (no maintenance), effective 2006-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator51: drugs
BETOS categoryI1E: standard imaging - nuclear medicine
Type of service4: diagnostic radiology

Medicare payment for A4641

The physician fee schedule lists A4641 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status C: contractor-priced: the MAC sets RVUs and payment case by case. Global period XXX (global surgery concept does not apply); PC/TC indicator 0 (physician service; the professional/technical split does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for A4641

CMS publishes no MUE for A4641 in the 2026 Q4 practitioner, facility or DME supplier tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the quantity furnished on every claim.

The MUE lookup for A4641 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, A4641 is the column-2 (bundled) code in 12 active pairs, 0% of which allow a modifier and the column-1 code in 0; 5 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with A4641 (practitioner)
Column-1 codePairs
78432 (CPT; descriptor licensed by AMA)1
78433 (CPT; descriptor licensed by AMA)1
78459 (CPT; descriptor licensed by AMA)1
78491 (CPT; descriptor licensed by AMA)1
78492 (CPT; descriptor licensed by AMA)1
78608 (CPT; descriptor licensed by AMA)1
78811 (CPT; descriptor licensed by AMA)1
78812 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, A4641 is the column-2 (bundled) code in 12 active pairs, 0% of which allow a modifier and the column-1 code in 0; 5 earlier pairs have been deleted. CMS's most frequent rationale for the bundled pairs: Misuse of Column Two code with Column One code.

Column-1 codes most often paired with A4641 (hospital outpatient)
Column-1 codePairs
78432 (CPT; descriptor licensed by AMA)1
78433 (CPT; descriptor licensed by AMA)1
78459 (CPT; descriptor licensed by AMA)1
78491 (CPT; descriptor licensed by AMA)1
78492 (CPT; descriptor licensed by AMA)1
78608 (CPT; descriptor licensed by AMA)1
78811 (CPT; descriptor licensed by AMA)1
78812 (CPT; descriptor licensed by AMA)1

A4641 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check A4641 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A4641

1 active Local Coverage Determination and 3 billing and coding articles list A4641. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing A4641
ArticleTitleContractor(s)Related LCD
A52437Billing and Coding: Sentinel Lymph Node Biopsy – Medical Policy ArticleCGS Administrators, LLC—
A54880Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label IndicationsPalmetto GBA—
A56476Billing and Coding: Cardiac Radionuclide ImagingPalmetto GBAL33457

Denials to expect on A4641

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A4641

CARC 151 · N362

units exceed what the payer considers medically likely for one date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for A4641 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A4641 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A4641

What does HCPCS code A4641 describe?

"Radiopharmaceutical, diagnostic, not otherwise classified" (short descriptor "Radiopharm dx agent noc"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1994-01-01; last action N (no maintenance) effective 2006-01-01.

Is A4641 a CPT code?

It is not. A4641 belongs to the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational) of HCPCS Level II, the CMS code set, not to AMA CPT. "A4641 CPT code" searches refer to it.

What does Medicare pay for A4641?

The physician fee schedule lists A4641 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it.

Does Medicare cover A4641?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 3 billing and coding articles list A4641 across 6 states: L33457 (Cardiac Radionuclide Imaging), A52437, A54880.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.