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HCPCS Q9963 · Level II · Part B drug

HCPCS Q9963: High osmolar contrast material, 350-399 mg/ml iodine concentration, 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 Q9963

Billing unit
1 ML
Hocm 350-399mg/ml iodine,1ml
ASP payment limit
$0.219
October 2026; +2.3% vs July 2026
Practitioner MUE
240
MAI 3
OPPS status
SI N
NCCI exposure
0 col-2 pairs
Coverage articles
0
none list this code

TL;DR

HCPCS Q9963 is the Level II code for High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml, billed per 1 ML. The Medicare Part B ASP payment limit for October 2026 is $0.219 per billing unit, up 2.3% from July 2026. The practitioner MUE allows up to 240 units per date of service (MAI 3). Under OPPS it carries status indicator N. Diagnostic agents are usually packaged under OPPS (status N) in the hospital outpatient setting, so separate payment applies mainly in the physician office under Part B. The ASP crosswalk maps 3 NDCs to it, sold as Md Gastroview, Gastrografin by Liebel-Flarsheim Company LLC, Bracco Diagnostics Inc.. No current Billing and Coding Article lists Q9963, 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 Q9963 at $0.219 per 1 ML for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.214 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for Q9963
QuarterPayment limitPerCoinsurance
October 2026$0.2191 ML20%
July 2026$0.2141 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 3 NDCs from 2 labelers to Q9963. Report the NDC in the claim's drug segment and bill the number of Q9963 units that equals the quantity administered divided by 1 ML; the last column gives units per full package.

NDCs that crosswalk to Q9963
NDCDrug nameLabelerPackage sizeBilling units / package
00019-4816-04Md GastroviewLiebel-Flarsheim Company LLC30 × 25750
00270-0445-35GastrografinBracco Diagnostics Inc.30 × 24720
00270-0445-40GastrografinBracco Diagnostics Inc.120 × 121440

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for Q9963. For practitioners the limit is 240 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 Q9963 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services2403 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital2403 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

In the practitioner PTP file v323r0 (effective October 1, 2026), Q9963 is the column-2 code in 0 active pairs, and the column-1 code in 10. 0 historical pairs have been deleted over time.

These codes are considered components of Q9963 when reported together on the same date of service.

Column-2 codes most often bundled into Q9963
Column-2 codePairs
Q9951 Locm >= 400 mg/ml iodine,1ml1
Q9958 Hocm <=149 mg/ml iodine, 1ml1
Q9959 Hocm 150-199mg/ml iodine,1ml1
Q9960 Hocm 200-249mg/ml iodine,1ml1
Q9961 Hocm 250-299mg/ml iodine,1ml1
Q9962 Hocm 300-349mg/ml iodine,1ml1
Q9964 Hocm>= 400mg/ml iodine, 1ml1
Q9965 Locm 100-199mg/ml iodine,1ml1
Q9966 Locm 200-299mg/ml iodine,1ml1
Q9967 Locm 300-399mg/ml iodine,1ml1

Q9963 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 Q9963 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, Q9963 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for Q9963 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 Q9963 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 Q9963

What does HCPCS code Q9963 describe?

Q9963 is defined by CMS as "High osmolar contrast material, 350-399 mg/ml iodine concentration, 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 Q9963 in October 2026?

The ASP-based payment limit is $0.219 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 $0.214.

How many units of Q9963 can be billed per day?

The practitioner Medically Unlikely Edit is 240 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 "Prescribing Information" as the rationale.

Which NDCs map to Q9963?

The October 2026 ASP crosswalk lists 3 NDCs from 2 labelers: Md Gastroview (Liebel-Flarsheim Company LLC); Gastrografin (Bracco Diagnostics Inc.). For example NDC 00019-4816-04 is a 30 package equal to 750 billing units. The crosswalk's billing-units-per-package figure converts each package into Q9963 units.

Does Q9963 have NCCI bundling edits?

In the v323r0 practitioner PTP file, Q9963 appears as the column-2 (bundled) code in 0 active pairs and as the column-1 code in 10. The most frequent column-1 partners are .

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.