P9040 HCPCS code: Red blood cells, leukocytes reduced, irradiated, each unit
P9040 is the HCPCS Level II code for red blood cells, leukocytes reduced, irradiated, each unit. In 2024 Medicare paid an average of $196.11 per service for P9040 across 912 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 57% from 2022 to 2024 (2,125 to 912 services). In 2024, about 139 clinicians billed Medicare for P9040 for 209 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 | 2001-01-01 |
| Last action effective | 2001-01-01 |
Who bills P9040 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 139 |
| Medicare beneficiaries | 209 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for P9040, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,125 | 403 | $269.41 | $214.93 |
| 2023 | 1,448 | 331 | $232.69 | $185.40 |
| 2024 | 912 | 209 | $246.13 | $196.11 |
States with the most P9040 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Missouri | 633 | $180.79 |
| California | 72 | $86.87 |
| Maryland | 46 | $198.74 |
| Illinois | 37 | $57.48 |
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 P9040
- 2001-01-01: P9040 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 P9040?
P9040 is the HCPCS Level II code for red blood cells, leukocytes reduced, irradiated, each unit. Short descriptor: "Rbc leukoreduced irradiated".
How much does Medicare pay for P9040?
In 2024, the average Medicare payment was $196.11 per service (average allowed $246.13).
Does Medicare cover P9040?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9040 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
- 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
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Next steps
- Run a reimbursement report for a device billed under P9040
- Watch P9040 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for P9040
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.