P9043 HCPCS code: Infusion, plasma protein fraction (human), 5%, 50 ml
P9043 is the HCPCS Level II code for infusion, plasma protein fraction (human), 5%, 50 ml. 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 10 per day on outpatient hospital claims.
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 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Prescribing Information |
| practitioner claims | 5 | Prescribing Information |
What changed for P9043
- 2001-01-01: P9043 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 P9043?
P9043 is the HCPCS Level II code for infusion, plasma protein fraction (human), 5%, 50 ml. Short descriptor: "Plasma protein fract,5%,50ml".
Does Medicare cover P9043?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of P9043 can be billed per day?
10 on outpatient hospital claims; 5 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 P9043
- Watch P9043 for fee, coverage and descriptor changes
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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.