Home › Drug Codes › A Codes › A9573 · ELUCIREM
Updated July 1st, 2026

ELUCIREM A Code: A9573

Injection, gadopiclenol, 1 ml

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Q4 2026 Medicare Payment Limit for A9573, effective October 1, 2026: $3.222 per HCPCS billing unit, up 2.2% from $3.152. From CMS's final file.

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Medicare Payment Limit ?
$3.152
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
26
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Drug & Product Overview

HCPCS Descriptor Injection, gadopiclenol, 1 ml
HCPCS Added Date October 1, 2023
Manufacturer Guerbet
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About ELUCIREM

Elucirem is a medication aligned to the HCPCS A Code: A9573 for billing, pricing, and reimbursement purposes in the United States. This Imaging/Radiopharmaceutical medication is administered via the intravenous route and manufactured by Guerbet.

According to CMS Drug Use Information: This medication is used before a magnetic resonance imaging (MRI) scan. It belongs to a class of drugs known as gadolinium-based contrast agents (GBCAs). This medication helps the MRI scan make clearer images, so your doctor can more easily diagnose your condition.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 26 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00270-7015-46 Vueway BRACCO DIAGNOSTICS INC 750 14553 MG / 30 ML
00270-7015-48 Vueway BRACCO DIAGNOSTICS INC 1250 24255 MG / 50 ML
00270-7025-40 Vueway BRACCO DIAGNOSTICS INC 75 3638.25 MG / 7.5 ML
00270-7030-42 Vueway BRACCO DIAGNOSTICS INC 100 4851 MG / 10 ML
67684-4230-02 Elucirem Guerbet LLC 30 1455.3 MG / 3 ML
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ELUCIREM Pricing & Reimbursement

A9573 Private Payer Reimbursement
$3.27 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

ELUCIREM CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug), IV push, single, or initial substance/drug
Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

ELUCIREM Medically Unlikely Edits (MUE)

The most billing units of A9573 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 ml.

Practitioner Office & Hospital Outpatient
18 units / day
= 18 ml per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

ml Enter a dose to see how many billing units it is and whether it is under the limit.

ELUCIREM Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Lesions with abnormal vascularity in the body (head and neck, thorax, abdomen, pelvis, and musculoskeletal system) Lesions with abnormal vascularity in the central nervous system (brain, spine, and associated tissues) lesions with abnormal vascularity in the body (head and neck, thorax, abdomen, pelvis, and musculoskeletal system) lesions with abnormal vascularity in the central nervous system (brain, spine, and associated tissues)

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Frequently Asked Questions

Is there a manufacturer-published billing and coding guide for Elucirem?
Our team has not identified a manufacturer-published source of billing and coding information for Elucirem.
Are there any available patient assistance programs for Elucirem?
Our team has not identified a source of patient assistance information for Elucirem.
Where can I find Elucirem prescribing information?
Elucirem prescribing information can be found at the link below. Visit Here →
Is there available side effect information for Elucirem?
Our team has not identified a source of side effect information for Elucirem.
Does billing ELUCIREM require JZ/JW wastage modifiers?
CMS does not include ELUCIREM (A9573) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing A9573. For more information, visit the link below.

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