HCPCS A9507 Medicare carrier-priced amount: $1,617.72 on file (Q3 2026)

Contractor-priced

A9507 · PFS Q3 2026 · Historical

Contractor-published range

$1,617.72

Participating · Office (non-facility) · Whole service

MAC-published fee schedules available in Localis: 3 of 144 payment localities. Missing data does not establish a $0 allowance.

No national PFS rate in Q3 2026

Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Check for a published amount in your locality.

Service-location ZIP

View contractor sources and effective dates

Amount evidence: MAC-published fee schedules and effective dates. The PFS row shows this code is priced by the contractor.

Inspect PFS status evidence

Code: A9507
Release: Q3 2026, revision 1
Result: Contractor-priced

Citations

Shows this code’s PFS status (C). Result: Contractor-priced.

Physician relative value file (PPRRVU)CMS RVU26CJuly 1 – September 30, 2026

This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

PPRRVU2026_Jul_nonQPP.csv row 13,874 in rvu26c-updated-06-30-2026.zip

In the CMS file

Loading rows 13,872–13,876 of PPRRVU2026_Jul_nonQPP.csv…

Download rvu26c-updated-06-30-2026.zip from CMS File fingerprint b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

Report a problem

HCPCS A9507 carries status C (carrier-priced) in the Q3 2026 release, so there is no single national rate—Medicare contractors publish their own amounts. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Contractor-published amounts on file range $1,617.72 across 3 localities; enter a ZIP for the exact local amount.

Why is there no national PFS amount for A9507?

Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

About this code

In111 capromab

Find the local Medicare amount for A9507 Copy link

Medicare sets this price locally

A9507 has no single national Physician Fee Schedule amount. Use the ZIP, modifier, setting, and participation fields above to match it to a Medicare locality and the contractor amount we have on file.

Your practical estimate will appear here

We hold files from First_coast across JN, most recently effective Jan 1, 2022. A missing locality means our contractor coverage is incomplete—not that Medicare pays $0.

This is the published amount for this code—not necessarily the entire visit or procedure. A hospital may bill a separate facility charge, and other services, drugs, or supplies can add to the total.

Contractor-published source figures, not a national rate. Par = participating-provider amount Non-par = nonparticipating-provider amount C = technical component capped at the OPPS amount # = facility-setting amount

View all 3 published fee rows

Jurisdiction / locality	Modifier	Note	Par	Non-par	Limiting charge	Effective	Source
JN · Florida, Area 03 CMS 09102-03	—	—	$1,617.72	$1,536.83	$1,767.35	Jan 1, 2022	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	—	$1,617.72	$1,536.83	$1,767.35	Jan 1, 2022	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	—	$1,617.72	$1,536.83	$1,767.35	Jan 1, 2022	Contractor file

The authenticated MAC fees API returns the same source rows. ZIP5s that span localities are flagged and use only the crosswalk's dominant locality until ZIP+4 overrides are available.

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust A9507's amount.

Global surgery period XXX (does not apply).

Why would a Medicare claim for A9507 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
7 codes form NCCI pairs with A9507 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
2 codes pair with A9507 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
Bilateral surgery: no bilateral adjustment. See billing policy
Assistant at surgery: restricted without documentation. See billing policy
Co-surgeons: not permitted. See billing policy
Team surgery: not permitted. See billing policy

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

CMS RVU26CJuly 1 – September 30, 2026

Can you bill it with another code? Copy link

A9507 has 9 NCCI pairs (Q3 2026).

Modifier indicator 0

7 pairs

No modifier bypasses the edit

78070
78216
78226
+4 more

Modifier indicator 1

2 pairs

Only with an appropriate, documented modifier

78300
78306

All 9 NCCI pairs for A9507 →

Reconciling a contractor-priced payment for A9507 Copy link

Checking a paid A9507 line?

Check an actual payment Model this code in a contract

What to check (3)

There is no national allowed amount for A9507, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.

Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
Check for documentation on file before appealing an assistant-at-surgery denial: payment on the -80 or -AS line is restricted for this procedure unless medical necessity is established.
Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

Source & method Copy link

The PFS file shows this code is priced by the contractor. Its amounts come from the MAC-published schedules and effective dates shown above.

01 PPRRVU2026_Jul_nonQPP.csv · Q3 2026 (RVU26C) · row 13,874—priced by the contractor

Source

Physician relative value file (PPRRVU), Q3 2026 release

Effective

July 1 – September 30, 2026

Locator

PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip · row 13,874 of 19,356 · via CMS

Fields read

Status C (col 4)

SHA-256 b7d197e73211ef68…
02 MAC-published fee schedules · 3 on file—the contractor amounts

Source

MAC-published fee schedules

Effective

Effective dates shown above
03 NCCI · Q3 2026—the code-pair edits

Source

National Correct Coding Initiative (NCCI)

Effective

Same quarter as the Q3 2026 rate

Cite this rate

HCPCS A9507 National PFS baseline: No national PFS rate (Q3 2026; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU26C, PPRRVU2026_Jul_nonQPP.csv row 13,874. Localis. https://localishealth.com/hcpcs/A9507/2026/C

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. CMS owns the code description shown for HCPCS Level II codes. Methodology · Plain-text summary · JSON

How has it changed? Copy link

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Did this answer your question about HCPCS A9507?

Tell us what you were trying to work out and we'll answer you or build the page that does.