Q0498 HCPCS code: Holster for use with electric or electric/pneumatic ventricular assist device, replacement only
Q0498 is the HCPCS Level II code for holster for use with electric or electric/pneumatic ventricular assist device, replacement only. The 2026 Medicare DMEPOS fee schedule pays $617.36 to $679.11 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 19% from 2022 to 2024 (84 to 68 services). In 2024, about 7 clinicians billed Medicare for Q0498 for 58 beneficiaries. Its average fee ranks 10 of 22 Q04 codes (family range $109.14–$110,374.73).
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2005-10-01 |
| Last action effective | 2013-01-01 |
2026 Medicare DMEPOS fee schedule for Q0498
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $617.36 | $679.11 | $753.56 | $565.17 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $617.36 | — |
| AL | — | $635.90 | — |
| AR | — | $635.84 | — |
| AZ | — | $617.36 | — |
| CA | — | $617.36 | — |
| CO | — | $640.70 | — |
| CT | — | $617.36 | — |
| DC | — | $617.36 | — |
| DE | — | $617.36 | — |
| FL | — | $635.90 | — |
| GA | — | $635.90 | — |
| HI | — | $617.36 | — |
| IA | — | $629.41 | — |
| ID | — | $617.36 | — |
| IL | — | $632.48 | — |
| IN | — | $632.48 | — |
| KS | — | $629.41 | — |
| KY | — | $635.90 | — |
| LA | — | $635.84 | — |
| MA | — | $617.36 | — |
| MD | — | $617.36 | — |
| ME | — | $617.36 | — |
| MI | — | $632.48 | — |
| MN | — | $632.48 | — |
| MO | — | $629.41 | — |
| MS | — | $635.90 | — |
| MT | — | $640.70 | — |
| NC | — | $635.90 | — |
| ND | — | $640.70 | — |
| NE | — | $629.41 | — |
| NH | — | $617.36 | — |
| NJ | — | $617.36 | — |
| NM | — | $635.84 | — |
| NV | — | $617.36 | — |
| NY | — | $617.36 | — |
| OH | — | $632.48 | — |
| OK | — | $635.84 | — |
| OR | — | $617.36 | — |
| PA | — | $617.36 | — |
| PR | — | $679.11 | — |
| RI | — | $617.36 | — |
| SC | — | $635.90 | — |
| SD | — | $640.70 | — |
| TN | — | $635.90 | — |
| TX | — | $635.84 | — |
| UT | — | $640.70 | — |
| VA | — | $617.36 | — |
| VI | — | $679.11 | — |
| VT | — | $617.36 | — |
| WA | — | $617.36 | — |
| WI | — | $632.48 | — |
| WV | — | $617.36 | — |
| WY | — | $640.70 | — |
How the Q0498 fee compares
| Measure | Value |
|---|---|
| Rank among 22 Q04 codes (lowest = 1) | 10 |
| Family fee range (average of state fees) | $109.14–$110,374.73 |
| Rural fee uplift | — |
Who bills Q0498 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 7 |
| Medicare beneficiaries | 58 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q0498, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 84 | 72 | $533.42 | $425.83 |
| 2023 | 63 | 59 | $571.76 | $448.58 |
| 2024 | 68 | 58 | $603.75 | $481.03 |
States with the most Q0498 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 52 | $469.20 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
| practitioner claims | 1 | Clinical: Data |
What changed for Q0498
- 2026-01-01: Average state fee rose 2.0%: $617.15 to $629.50
- 2005-10-01: Q0498 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 Q0498?
Q0498 is the HCPCS Level II code for holster for use with electric or electric/pneumatic ventricular assist device, replacement only. Short descriptor: "Holster elec/combo vad, rep".
How much does Medicare pay for Q0498?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $617.36–$679.11. Rural fees can be higher.
Does Medicare cover Q0498?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for Q0498 change in 2026?
The average non-rural state fee moved from $617.15 in 2025 to $629.50 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of Q0498 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related Q04 codes
- Q0477 — Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only ($932.39–$967.76)
- Q0478 — Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type ($220.87–$229.21)
- Q0479 — Power module for use with electric or electric/pneumatic ventricular assist device, replacement only ($14,368.26–$14,943.26)
- Q0480 — Driver for use with pneumatic ventricular assist device, replacement only ($108,243.35–$119,067.63)
- Q0481 — Microprocessor control unit for use with electric ventricular assist device, replacement only ($17,463.78–$19,210.18)
- Q0482 — Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only ($5,469.98–$6,016.97)
- Q0483 — Monitor/display module for use with electric ventricular assist device, replacement only ($22,533.92–$24,787.32)
- Q0484 — Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only ($4,376.02–$4,813.57)
- Q0485 — Monitor control cable for use with electric ventricular assist device, replacement only ($422.47–$464.76)
- Q0486 — Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only ($351.65–$386.80)
- Q0487 — Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only ($410.25–$451.27)
- Q0488 — Power pack base for use with electric ventricular assist device, replacement only
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 Q0498
- Watch Q0498 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q0498
Sources: CMS HCPCS Level II release October 2026; 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.