Q9956 HCPCS code: Injection, octafluoropropane microspheres, per ml
Q9956 is the HCPCS Level II code for injection, octafluoropropane microspheres, per ml. In 2024 Medicare paid an average of $31.82 per service for Q9956 across 17,219 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 9 per day on outpatient hospital claims. In 2024, about 536 clinicians billed Medicare for Q9956 for 6,383 beneficiaries; Missouri, Texas, Illinois accounted for 50% of services.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 57 |
| BETOS category | I1F |
| Added | 2005-04-01 |
| Last action effective | 2005-04-01 |
Who bills Q9956 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 536 |
| Medicare beneficiaries | 6,383 |
| States with claims | 24 |
| Share of services in top 3 states (Missouri, Texas, Illinois) | 50% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q9956, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 17,183 | 6,299 | $29.96 | $23.22 |
| 2023 | 18,616 | 6,730 | $36.00 | $28.01 |
| 2024 | 17,219 | 6,383 | $41.27 | $31.82 |
States with the most Q9956 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Missouri | 4,355 | $31.62 |
| Texas | 2,165 | $32.83 |
| Illinois | 1,971 | $31.89 |
| Wisconsin | 1,928 | $31.95 |
| Minnesota | 1,537 | $31.65 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 9 | Prescribing Information |
| practitioner claims | 9 | Prescribing Information |
Medicare policy articles for this code
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A58503: Billing and Coding: Echocardiography for Myocardial Perfusion (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (1,839 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| I21.01 | ST elevation (STEMI) myocardial infarction involving left main coronary artery | 4 |
| I21.02 | ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery | 4 |
| I21.09 | ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall | 4 |
| I21.11 | ST elevation (STEMI) myocardial infarction involving right coronary artery | 4 |
| I21.19 | ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall | 4 |
| I21.21 | ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery | 4 |
| I21.4 | Non-ST elevation (NSTEMI) myocardial infarction | 4 |
| I22.0 | Subsequent ST elevation (STEMI) myocardial infarction of anterior wall | 4 |
| I22.1 | Subsequent ST elevation (STEMI) myocardial infarction of inferior wall | 4 |
| I22.2 | Subsequent non-ST elevation (NSTEMI) myocardial infarction | 4 |
Showing 10 of 1,839. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for Q9956
- 2005-04-01: Q9956 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 Q9956?
Q9956 is the HCPCS Level II code for injection, octafluoropropane microspheres, per ml. Short descriptor: "Inj octafluoropropane mic,ml".
How much does Medicare pay for Q9956?
In 2024, the average Medicare payment was $31.82 per service (average allowed $41.27).
Does Medicare cover Q9956?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for Q9956?
Medicare policy articles that cite Q9956 list 1,839 covered ICD-10-CM diagnosis codes across 4 articles. The most cited include I21.01 (ST elevation (STEMI) myocardial infarction involving left main coronary artery), I21.02 (ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery), I21.09 (ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of Q9956 can be billed per day?
9 on outpatient hospital claims; 9 on practitioner claims (NCCI medically unlikely edits).
Related Q99 codes
- Q9950 — Injection, sulfur hexafluoride lipid microspheres, per ml
- Q9951 — Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
- Q9953 — Injection, iron-based magnetic resonance contrast agent, per ml
- Q9954 — Oral magnetic resonance contrast agent, per 100 ml
- Q9955 — Injection, perflexane lipid microspheres, per ml
- Q9957 — Injection, perflutren lipid microspheres, per ml
- Q9958 — High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml
- Q9959 — High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml
- Q9960 — High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml
- Q9961 — High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml
- Q9962 — High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml
- Q9963 — High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
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 Q9956
- Watch Q9956 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9956
Sources: CMS HCPCS Level II release October 2026; 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.