P9021 HCPCS code: Red blood cells, each unit
P9021 is the HCPCS Level II code for red blood cells, each unit. In 2024 Medicare paid an average of $134.29 per service for P9021 across 91 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 8 per day on outpatient hospital claims. Medicare volume fell 58% from 2022 to 2024 (215 to 91 services). In 2024, about 22 clinicians billed Medicare for P9021 for 26 beneficiaries.
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 P9021 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 22 |
| Medicare beneficiaries | 26 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for P9021, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 215 | 93 | $101.67 | $81.07 |
| 2023 | 190 | 56 | $202.52 | $161.36 |
| 2024 | 91 | 26 | $168.55 | $134.29 |
States with the most P9021 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 35 | $27.55 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 8 | Clinical: Data |
| practitioner claims | 3 | Clinical: Data |
What changed for P9021
- 1987-01-01: P9021 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 P9021?
P9021 is the HCPCS Level II code for red blood cells, each unit. Short descriptor: "Red blood cells unit".
How much does Medicare pay for P9021?
In 2024, the average Medicare payment was $134.29 per service (average allowed $168.55).
Does Medicare cover P9021?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9021 can be billed per day?
8 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
- P9016 — Red blood cells, leukocytes reduced, 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
- 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 P9021
- Watch P9021 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for P9021
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.