P9046 HCPCS code: Infusion, albumin (human), 25%, 20 ml
P9046 is the HCPCS Level II code for infusion, albumin (human), 25%, 20 ml. In 2024 Medicare paid an average of $16.58 per service for P9046 across 3,275 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 40 per day on outpatient hospital claims. Medicare volume fell 30% from 2022 to 2024 (4,647 to 3,275 services). In 2024, about 178 clinicians billed Medicare for P9046 for 140 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | P codes — Pathology and laboratory services |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 52 |
| BETOS category | Y2 |
| Added | 2002-01-01 |
| Last action effective | 2002-01-01 |
Who bills P9046 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 178 |
| Medicare beneficiaries | 140 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for P9046, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 4,647 | 161 | $20.65 | $16.37 |
| 2023 | 3,486 | 157 | $20.83 | $16.49 |
| 2024 | 3,275 | 140 | $20.89 | $16.58 |
States with the most P9046 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 2,118 | $16.62 |
| Texas | 386 | $16.63 |
| Tennessee | 188 | $16.47 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 40 | Clinical: Data |
| practitioner claims | 25 | Clinical: Data |
What changed for P9046
- 2002-01-01: P9046 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 P9046?
P9046 is the HCPCS Level II code for infusion, albumin (human), 25%, 20 ml. Short descriptor: "Albumin (human), 25%, 20 ml".
How much does Medicare pay for P9046?
In 2024, the average Medicare payment was $16.58 per service (average allowed $20.89).
Does Medicare cover P9046?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of P9046 can be billed per day?
40 on outpatient hospital claims; 25 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under P9046
- Watch P9046 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for P9046
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.