HCPCS Code A9607: Lutetium Lu 177 Vipivotide Tetraxetan, Therapeutic, 1 millicurie

Each one mCi equals one billing unit. For a 200 mCi dose, you would submit 200 units of A9607.

Use JZ if no drug amount is discarded and JW if any portion is discarded. Modifier UD is used for 340B-purchased drugs in Medicaid PADP contexts.

Yes—Pluvicto has transitional pass-through status under OPPS (status indicator “G”) through September 30, 2025, allowing separate outpatient payment.