R57.0: Cardiogenic shock
R57.0, cardiogenic shock, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 33 HCPCS Level II codes, including Q9957 (Injection, perflutren lipid microspheres, per ml), Q9956 (Injection, octafluoropropane microspheres, per ml), Q9955 (Injection, perflexane lipid microspheres, per ml). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with R57.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 4 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 4 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 4 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 4 |
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 4 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 4 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 4 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 4 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 4 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 4 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 4 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 4 |
| Q9950 | Injection, sulfur hexafluoride lipid microspheres, per ml | Carrier judgment | — | 1 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 2 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 2 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 2 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 2 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 1 |
| G0269 | Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug) | Special coverage instructions apply | — | 1 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 1 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 1 |
8 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing R57.0
- A58503: Billing and Coding: Echocardiography for Myocardial Perfusion (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L38786
- A57179: Billing and Coding: Transesophageal Echocardiogram (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33756
- A56809: Billing and Coding: Transesophageal Echocardiography (TEE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- A56500: Billing and Coding: Cardiac Catheterization and Coronary Angiography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- A52868: Billing and Coding: Transesophageal Echocardiography (TEE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33579, L34337, L35016
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other R57 diagnoses (Shock, not elsewhere classified)
Frequently asked questions
Does Medicare cover R57.0 (Cardiogenic shock)?
Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list R57.0 as a covered diagnosis for 33 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 R57.0?
The Level II codes from the policies most specific to this diagnosis are Q9957 (Injection, perflutren lipid microspheres, per ml, 4 articles); Q9956 (Injection, octafluoropropane microspheres, per ml, 4 articles); Q9955 (Injection, perflexane lipid microspheres, per ml, 4 articles); A9700 (Supply of injectable contrast material for use in…, 4 articles); C8925 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R57.0?
A58503 (Billing and Coding: Echocardiography for Myocardial Perfusion); A57179 (Billing and Coding: Transesophageal Echocardiogram); A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)), and 7 more articles.
What is ICD-10-CM code R57.0?
R57.0 is the ICD-10-CM code for cardiogenic shock, in category R57 (Shock, not elsewhere classified), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under Q9957
- Watch Q9957 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9957
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup