Summary & Overview
HCPCS C9067: Gallium Ga-68 DOTATOC, Diagnostic, 0.01 mCi
HCPCS Level II code C9067 denotes Gallium Ga-68 DOTATOC, a radiopharmaceutical diagnostic agent (0.01 mCi) used in PET imaging to detect somatostatin receptor–positive tumors such as neuroendocrine tumors. Nationally, availability and coding for Ga-68–based somatostatin receptor imaging matter because these agents improve diagnostic sensitivity and can affect care pathways, imaging utilization, and reimbursement for advanced molecular imaging.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus benchmarks and policy-relevant details where available. The publication outlines common billing considerations, typical modifiers used with radiopharmaceutical codes, and payer coverage patterns when available.
This summary equips clinical administrators, coding specialists, and policy analysts with background on the code’s clinical purpose, the service environment in which it is delivered, and the payer landscape to expect. Data not available in the input is noted where relevant.
Billing Code Overview
HCPCS Level II code C9067 describes Gallium Ga-68 DOTATOC, diagnostic, 0.01 mCi. This code represents a radiopharmaceutical diagnostic agent used for somatostatin receptor imaging, typically administered for positron emission tomography (PET) scans to evaluate neuroendocrine tumors and other somatostatin receptor–expressing lesions.
Service type: Radiopharmaceutical diagnostic agent for PET imaging.
Typical site of service: Hospital outpatient imaging centers, nuclear medicine departments, and freestanding PET/CT imaging centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old with known or suspected neuroendocrine tumor (NET) presenting for localization and staging. The clinician orders a Gallium Ga-68 DOTATOC PET/CT to identify somatostatin receptor–expressing lesions after biochemical evidence (elevated chromogranin A) or equivocal conventional imaging. The workflow: patient check-in and verification of indication and allergies; IV access is obtained; radiopharmacy prepares and performs quality check of C9067 Gallium Ga-68 DOTATOC dose per institutional protocol; the tracer (measured in increments of 0.01 mCi per billing descriptor) is administered intravenously; uptake time (typically 45–90 minutes) is observed; patient undergoes PET/CT imaging in a nuclear medicine suite with technologist and nuclear medicine physician oversight; images are reconstructed and interpreted by a nuclear medicine/radiology physician; a written report is generated, returned to the ordering oncologist or endocrinologist, and used to guide staging, surgical planning, peptide receptor radionuclide therapy candidacy, or systemic therapy decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no service modifier applies. |