A4642 — Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
A4642 is a HCPCS Level II code for indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusC
Contractor-priced. Your MAC establishes the RVUs and the payment amount case by case, usually after reviewing documentation. There is no national amount to compute.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4642 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4642
- Long descriptor
- Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
- Short descriptor
- In111 satumomab
- Added
- January 1, 1995
- BETOS
- I1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to A4642
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4642 is not quite right, the correct code is very often within a few positions of it.
- A4634Replacement bulb for therapeutic light box, tabletop model
- A4635Underarm pad, crutch, replacement, each
- A4636Replacement, handgrip, cane, crutch, or walker, each
- A4637Replacement, tip, cane, crutch, walker, each.
- A4638Replacement battery for patient-owned ear pulse generator, each
- A4639Replacement pad for infrared heating pad system, each
- A4640Replacement pad for use with medically necessary alternating pressure pad owned by patient
- A4641Radiopharmaceutical, diagnostic, not otherwise classified
- A4648Tissue marker, implantable, any type, each
- A4649Surgical supply; miscellaneous
- A4650Implantable radiation dosimeter, each
- A4651Calibrated microcapillary tube, each
- A4652Microcapillary tube sealant
- A4653Peritoneal dialysis catheter anchoring device, belt, each
- A4657Syringe, with or without needle, each
- A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
Questions about A4642
What is HCPCS code A4642?
A4642 is a HCPCS Level II code for indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4642?
The CMS HCPCS file marks A4642 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4642 paid under the physician fee schedule?
A4642 carries PFS status code C. Contractor-priced. Your MAC establishes the RVUs and the payment amount case by case, usually after reviewing documentation. There is no national amount to compute.