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HCPCS A9577 · Level II · Part B drug

HCPCS A9577: Injection, gadobenate dimeglumine (multihance), per ml

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for A9577

Billing unit
1 ML
Inj multihance
ASP payment limit
$1.804
October 2026; +0.7% vs July 2026
Practitioner MUE
50
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS A9577 is the Level II code for Injection, gadobenate dimeglumine (multihance), per ml, billed per 1 ML. The Medicare Part B ASP payment limit for October 2026 is $1.804 per billing unit, up 0.7% from July 2026. The practitioner MUE allows up to 50 units per date of service (MAI 3). Under OPPS it carries status indicator N. A9577 is billed in units of 1 ML; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 4 NDCs to it, sold as Multihance by Bracco Diagnostics Inc.. No current Billing and Coding Article lists A9577, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for A9577 at $1.804 per 1 ML for October 2026, derived from manufacturer average sales price plus 6%, compared with $1.791 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for A9577
QuarterPayment limitPerCoinsurance
October 2026$1.8041 ML20%
July 2026$1.7911 ML—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 4 NDCs from 1 labeler to A9577. Report the NDC in the claim's drug segment and bill the number of A9577 units that equals the quantity administered divided by 1 ML; the last column gives units per full package.

NDCs that crosswalk to A9577
NDCDrug nameLabelerPackage sizeBilling units / package
00270-5164-12MultihanceBracco Diagnostics Inc.5 × 525
00270-5164-13MultihanceBracco Diagnostics Inc.10 × 550
00270-5164-14MultihanceBracco Diagnostics Inc.15 × 575
00270-5164-15MultihanceBracco Diagnostics Inc.20 × 5100

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for A9577. For practitioners the limit is 50 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for A9577 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services503 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital503 Date of Service Edit: ClinicalClinical: Data

NCCI edits and add-on relationships

No active practitioner PTP pair lists A9577 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

A9577 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists A9577 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, A9577 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for A9577 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks A9577 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS A9577

What does HCPCS code A9577 describe?

A9577 is defined by CMS as "Injection, gadobenate dimeglumine (multihance), per ml". Each billing unit represents 1 ML, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for A9577 in October 2026?

The ASP-based payment limit is $1.804 per 1 ML, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $1.791.

How many units of A9577 can be billed per day?

The practitioner Medically Unlikely Edit is 50 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Clinical: Data" as the rationale.

Which NDCs map to A9577?

The October 2026 ASP crosswalk lists 4 NDCs from 1 labeler: Multihance (Bracco Diagnostics Inc.). For example NDC 00270-5164-12 is a 5 package equal to 25 billing units. The crosswalk's billing-units-per-package figure converts each package into A9577 units.

Does A9577 have NCCI bundling edits?

No active practitioner PTP pairs list A9577 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.