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HCPCS A9552 · Level II · A code

A9552: Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries, 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 A9552

Medicare payment
no PFS amount
PFS status C
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
38
38 hospital outpatient
LCDs and articles
1 / 3

TL;DR

HCPCS Level II A9552 reads "Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries" in the October 2026 file; it dates from 2006. The physician fee schedule lists A9552 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). In the NCCI PTP files v323r0 A9552 appears in 38 practitioner pairs as column 2 and 0 as column 1 (most often with 0541T, 0542T, 0868T), and in 38 hospital outpatient pairs as column 2 and 0 as column 1. 1 active LCD and 3 billing and coding articles list A9552 across 7 states plus DC and 2 territories: L39521 (Positron Emission Tomography (PET) Scan for Inflammation and Infection), A53134, A59049. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS I1E (standard imaging - nuclear medicine); pricing indicator 53; type of service 4 (diagnostic radiology). Nearby codes: A9555, A9560, A9561, A9562.

A9552 descriptor and code status

The October 2026 HCPCS Level II file describes A9552 as “Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries”. 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 "A9552 CPT code", A9552 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 A9552
FieldValue
Short descriptorF18 fdg
Added to HCPCS2006-01-01
Last actionN (no maintenance), effective 2006-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator53: statute
BETOS categoryI1E: standard imaging - nuclear medicine
Type of service4: diagnostic radiology

Medicare payment for A9552

The physician fee schedule lists A9552 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.

Ambulatory surgical center (Addendum BB)

Payment indicator N1 (Packaged service/item; no separate payment made).

Medically Unlikely Edits for A9552

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for A9552 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction
Facility outpatient hospital13 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction

The MUE lookup for A9552 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

In the practitioner PTP file v323r0, A9552 is the column-2 (bundled) code in 38 active pairs, 58% of which allow a modifier and the column-1 code in 0; 14 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 A9552 (practitioner)
Column-1 codePairs
0541T (CPT; descriptor licensed by AMA)1
0542T (CPT; descriptor licensed by AMA)1
0868T (CPT; descriptor licensed by AMA)1
38792 (CPT; descriptor licensed by AMA)1
78018 (CPT; descriptor licensed by AMA)1
78070 (CPT; descriptor licensed by AMA)1
78075 (CPT; descriptor licensed by AMA)1
78195 (CPT; descriptor licensed by AMA)1

In the hospital outpatient PTP file v323r0, A9552 is the column-2 (bundled) code in 38 active pairs, 58% of which allow a modifier and the column-1 code in 0; 14 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 A9552 (hospital outpatient)
Column-1 codePairs
0541T (CPT; descriptor licensed by AMA)1
0542T (CPT; descriptor licensed by AMA)1
0868T (CPT; descriptor licensed by AMA)1
38792 (CPT; descriptor licensed by AMA)1
78018 (CPT; descriptor licensed by AMA)1
78070 (CPT; descriptor licensed by AMA)1
78075 (CPT; descriptor licensed by AMA)1
78195 (CPT; descriptor licensed by AMA)1

A9552 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 A9552 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A9552

1 active Local Coverage Determination and 3 billing and coding articles list A9552. 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 A9552
ArticleTitleContractor(s)Related LCD
A53134Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic ConditionsNovitas Solutions, Inc.—
A59049Billing and Coding: NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic ConditionsFirst Coast Service Options, Inc.—
A59318Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and InfectionCGS Administrators, LLCL39521

Denials to expect on A9552

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A9552

CARC 151 · N362

units of A9552 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for A9552 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A9552 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 A9552

What does HCPCS code A9552 describe?

"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries" (short descriptor "F18 fdg"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2006-01-01.

Is A9552 a CPT code?

No. A9552 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set. Searches for "A9552 CPT code" mean this Level II code.

What does Medicare pay for A9552?

The physician fee schedule lists A9552 with status C (contractor-priced: the MAC sets RVUs and payment case by case), so the PFS carries no national amount for it.

How many units of A9552 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Code Descriptor / CPT Instruction); hospital outpatient 1 (MAI 3, Code Descriptor / CPT Instruction). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A9552?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 3 billing and coding articles list A9552 across 7 states plus DC and 2 territories: L39521 (Positron Emission Tomography (PET) Scan for Inflammation and Infection), A53134, A59049.

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.