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    v1.0.28
    OpenPayerBilling CodesAdministrative, Miscellaneous and InvestigationalHCPCS hcpcs-a9552-fluorodeoxyglucose-fdg-per-study-dose-up-to-45-millicuries
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    HCPCS Level II A9552: Fluorodeoxyglucose F-18 (FDG), Diagnostic, Up to 45 mCi

    HCPCS Level II code A9552 describes a diagnostic radiopharmaceutical dose of Fluorodeoxyglucose F-18 (FDG), billed per study dose up to 45 millicuries, used for PET imaging studies; the service involves provision of the radiotracer for diagnostic nuclear medicine procedures, typically delivered in an outpatient imaging center, hospital nuclear medicine department, or freestanding PET/CT facility.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Table of contents

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    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with a history of non-small cell lung cancer presents for staging and assessment of suspected metastatic disease. The patient is referred for a diagnostic positron emission tomography (PET) scan using Fluorodeoxyglucose F-18 (FDG) to evaluate metabolic activity of a pulmonary mass and regional lymph nodes. The clinical workflow includes: referral by the oncology or pulmonary physician, review of indications and contraindications, patient fasting for at least 4–6 hours, blood glucose assessment prior to radiotracer injection, intravenous administration of FDG (up to 45 millicuries per study dose billed under A9552), uptake period (approximately 60 minutes), image acquisition on a PET or PET/CT scanner, image reconstruction and interpretation by a credentialed nuclear medicine physician or radiologist, and documentation of dose administered, lot number, and patient response.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78815Positron emission tomography (PET) imaging, skull base to mid-thigh; single day imagingCommon PET acquisition code used when FDG is administered for whole-body oncologic staging; pairs with radiopharmaceutical supply billed as A9552
    78811Positron emission tomography (PET) imaging, limited areaUsed for focused PET imaging of a single region when study is not whole-body; complements A9552 when lower dose or limited field is indicated
    78816PET imaging, skull base to mid-thigh with concurrent limited or regional imagingUsed when additional regional acquisition is performed in the same session alongside whole-body imaging
    78608PET attenuation correction/CT for PET/CT, when applicable (often reported as part of PET/CT protocol)CT component for attenuation correction and anatomic correlation performed with PET, typically billed by the facility or technical component
    0001MQuality and safety checklist for radionuclide administration (if applicable per payer/registry reporting)Used in workflows to document radiopharmaceutical safety checks and dose verification (reporting may vary by payer)

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    2086S0122XPlastic and Reconstructive Surgery PhysicianA surgeon who specializes in plastic and reconstructive surgery.
    207RR0500XRheumatology PhysicianAn internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, comm…
    251G00000XCommunity Based Hospice Care AgencyAgencies · Hospice Care, Community Based
    207ND0900XDermatopathology PhysicianA dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic dis…
    225200000XPhysical Therapy Assistant(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
    235500000XSpeech/Language/Hearing Specialist/TechnologistGeneral classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
    207PS0010XSports Medicine (Emergency Medicine) PhysicianAn emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the …

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    C16.9Malignant neoplasm of stomach, unspecified
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C22.0Liver cell carcinoma
    C25.9Malignant neoplasm of pancreas, unspecified
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C50.911Malignant neoplasm of unspecified site of right female breast
    C61Malignant neoplasm of prostate
    C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
    C67.9Malignant neoplasm of bladder, unspecified

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-A9150-NON-PRESCRIPTION-DRUGS

    HCPCS Level II A9150: Non-prescription Drugs

    HCPCS-A9152-SINGLE-ORAL-VITAMIN-MINERAL-DOSE

    HCPCS A9152: Single Oral Vitamin/Mineral/Trace Element

    HCPCS-A9153-MULTIVITAMIN-ORAL-PER-DOSE

    HCPCS A9153: Multiple Vitamins, Oral, Per Dose

    HCPCS-A9154-ARTIFICIAL-SALIVA-1ML

    HCPCS Level II A9154: Artificial saliva, 1 ml

    HCPCS-A9155-ARTIFICIAL-SALIVA-30ML

    HCPCS Level II A9155: Artificial Saliva, 30 mL

    HCPCS-A9156-ORAL-MUCOADHESIVE-PER-1ML

    HCPCS Level II A9156: Oral Mucoadhesive, Per 1 ml

    HCPCS-A9180-PEDICULOSIS-TOPICAL-TREATMENT-PATIENT-ADMINISTRATION

    HCPCS Level II A9180: Pediculosis Topical Treatment for Patient/Caretaker

    HCPCS-A9268-PROGRAMMER-TRANSIENT-INGESTED-CAPSULE

    HCPCS Level II A9268: Programmer for Transient Orally Ingested Capsule

    HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

    HCPCS Level II A9269: Programmable Orally Ingested Capsule, Per Month

    HCPCS-A9270-NON-COVERED-ITEM-OR-SERVICE

    HCPCS A9270: Non-covered Item or Service

    Showing 1–10 of 138

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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