P9016 HCPCS code: Red blood cells, leukocytes reduced, each unit
P9016 is the HCPCS Level II code for red blood cells, leukocytes reduced, each unit. In 2024 Medicare paid an average of $108.74 per service for P9016 across 2,403 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 12 per day on outpatient hospital claims. Medicare volume fell 13% from 2022 to 2024 (2,760 to 2,403 services). In 2024, about 148 clinicians billed Medicare for P9016 for 674 beneficiaries; Florida, Maryland, California accounted for 77% of services.
Code details
| Field | Value |
|---|---|
| Section | P codes — Pathology and laboratory services |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 52 |
| BETOS category | T1H |
| Added | 1987-01-01 |
| Last action effective | 2001-01-01 |
Who bills P9016 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 148 |
| Medicare beneficiaries | 674 |
| States with claims | 6 |
| Share of services in top 3 states (Florida, Maryland, California) | 77% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for P9016, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,760 | 916 | $116.29 | $92.81 |
| 2023 | 2,943 | 832 | $119.27 | $95.03 |
| 2024 | 2,403 | 674 | $136.48 | $108.74 |
States with the most P9016 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 610 | $54.33 |
| Maryland | 566 | $52.24 |
| California | 539 | $185.43 |
| Missouri | 301 | $87.15 |
| Oregon | 118 | $317.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Clinical: Data |
| practitioner claims | 3 | Clinical: Data |
What changed for P9016
- 1987-01-01: P9016 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code P9016?
P9016 is the HCPCS Level II code for red blood cells, leukocytes reduced, each unit. Short descriptor: "Rbc leukocytes reduced".
How much does Medicare pay for P9016?
In 2024, the average Medicare payment was $108.74 per service (average allowed $136.48).
Does Medicare cover P9016?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9016 can be billed per day?
12 on outpatient hospital claims; 3 on practitioner claims (NCCI medically unlikely edits).
Related P90 codes
- P9010 — Blood (whole), for transfusion, per unit
- P9011 — Blood, split unit
- P9012 — Cryoprecipitate, each unit
- P9017 — Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit
- P9019 — Platelets, each unit
- P9020 — Platelet rich plasma, each unit
- P9021 — Red blood cells, each unit
- P9022 — Red blood cells, washed, each unit
- P9023 — Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit
- P9025 — Plasma, cryoprecipitate reduced, pathogen reduced, each unit
- P9026 — Cryoprecipitated fibrinogen complex, pathogen reduced, each unit
- P9027 — Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit
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Next steps
- Run a reimbursement report for a device billed under P9016
- Watch P9016 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for P9016
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.