Q0481 HCPCS code: Microprocessor control unit for use with electric ventricular assist device, replacement only

Q0481 is the HCPCS Level II code for microprocessor control unit for use with electric ventricular assist device, replacement only. The 2026 Medicare DMEPOS fee schedule pays $17,463.78 to $19,210.18 depending on the state. 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 1 per day on outpatient hospital claims. Medicare volume fell 45% from 2022 to 2024 (116 to 64 services). In 2024, about 6 clinicians billed Medicare for Q0481 for 61 beneficiaries. Its average fee ranks 19 of 22 Q04 codes (family range $109.14–$110,374.73).

Code details

FieldValue
SectionQ codes — Temporary codes
Coverage codeD — Special coverage instructions apply
Pricing indicator38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services
BETOS categoryD1F — Prosthetic and orthotic devices
Added2005-10-01
Last action effective2013-01-01

2026 Medicare DMEPOS fee schedule for Q0481

ModifierMeaningLowest state feeHighest state feeCeilingFloor
—base fee$17,463.78$19,210.18$21,317.37$15,988.03
StateModifierFeeRural fee
AK—$17,463.78—
AL—$17,989.68—
AR—$17,987.99—
AZ—$17,463.78—
CA—$17,463.78—
CO—$18,125.09—
CT—$17,463.78—
DC—$17,463.78—
DE—$17,463.78—
FL—$17,989.68—
GA—$17,989.68—
HI—$17,463.78—
IA—$17,804.82—
ID—$17,463.78—
IL—$17,892.75—
IN—$17,892.75—
KS—$17,804.82—
KY—$17,989.68—
LA—$17,987.99—
MA—$17,463.78—
MD—$17,463.78—
ME—$17,463.78—
MI—$17,892.75—
MN—$17,892.75—
MO—$17,804.82—
MS—$17,989.68—
MT—$18,125.09—
NC—$17,989.68—
ND—$18,125.09—
NE—$17,804.82—
NH—$17,463.78—
NJ—$17,463.78—
NM—$17,987.99—
NV—$17,463.78—
NY—$17,463.78—
OH—$17,892.75—
OK—$17,987.99—
OR—$17,463.78—
PA—$17,463.78—
PR—$19,210.18—
RI—$17,463.78—
SC—$17,989.68—
SD—$18,125.09—
TN—$17,989.68—
TX—$17,987.99—
UT—$18,125.09—
VA—$17,463.78—
VI—$19,210.18—
VT—$17,463.78—
WA—$17,463.78—
WI—$17,892.75—
WV—$17,463.78—
WY—$18,125.09—

How the Q0481 fee compares

MeasureValue
Rank among 22 Q04 codes (lowest = 1)19
Family fee range (average of state fees)$109.14–$110,374.73
Rural fee uplift—

Who bills Q0481 (2024)

MeasureValue
Clinicians billing (by place of service)6
Medicare beneficiaries61
States with claims1

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for Q0481, 2022–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
2022116113$14,899.71$11,892.26
20238480$15,552.99$12,387.73
20246461$15,786.77$12,576.23

States with the most Q0481 services (2024)

StateServicesAvg. paid
Florida53$12,952.88

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims1Code Descriptor / CPT Instruction
practitioner claims1Code Descriptor / CPT Instruction

What changed for Q0481

Frequently asked questions

What is HCPCS code Q0481?

Q0481 is the HCPCS Level II code for microprocessor control unit for use with electric ventricular assist device, replacement only. Short descriptor: "Microprcsr cu elec vad, rep".

How much does Medicare pay for Q0481?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $17,463.78–$19,210.18. Rural fees can be higher.

Does Medicare cover Q0481?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Did the Medicare fee for Q0481 change in 2026?

The average non-rural state fee moved from $17,458.51 in 2025 to $17,807.68 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of Q0481 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).

Related Q04 codes

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

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; 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.

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