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Other ASP-priced HCPCS codes

4 ASP-priced codes with October 2026 Medicare payment limits, practitioner MUE values, NCCI column-2 exposure and the number of Medicare coverage articles that list each code. Open a code for its NDC billing-unit conversions, every MUE setting and the denial codes to expect.

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective

Codes in this range

4 of the 4 codes carry a published October 2026 payment limit; the remaining codes are priced by contractors or carry a limit of zero in the file.

ASP-priced codes in Other ASP-priced HCPCS codes
CodeDescriptorUnitLimitMUECol-2 pairsArticles
P9041Infusion, albumin (human), 5%, 50 ml50 ML$10.6165——
P9045Infusion, albumin (human), 5%, 250 ml250 ML$53.07920——
P9046Infusion, albumin (human), 25%, 20 ml20 ML$21.3325——
P9047Infusion, albumin (human), 25%, 50 ml50 ML$53.32420——

How to read this table

The limit is the Medicare Part B payment allowance per billing unit for the quarter shown, not per dose: multiply it by the units that the administered quantity divided by the descriptor unit produces. The MUE column is the practitioner-setting Medically Unlikely Edit, the maximum units CMS expects on one date of service; facility and DME limits can differ and appear on each code page. Column-2 pairs counts the active NCCI procedure-to-procedure edits in which the code is the bundled component, and Articles marks codes that at least one Medicare Administrative Contractor lists in a current Billing and Coding Article with covered diagnosis codes. Codes without a published limit are contractor-priced or carry a zero limit in the CMS file.

Frequently asked questions

How many codes are in other asp-priced hcpcs codes?

4 codes in this range carry an ASP payment limit in the October 2026 file; 2 have enough joined CMS data (MUE, NCCI, OPPS or coverage) to be published as full reference pages.

Which payers use these payment limits?

Medicare Part B contractors apply the ASP limits directly. Medicaid programs and commercial payers publish their own fee schedules, which often reference ASP but at different percentages.

Why do some codes show no MUE?

CMS withholds some MUE values as confidential and applies them without publication; others have no unit limit. A code with no published MUE can still deny for units when the quantity is implausible for the dose.

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

Operational reference compiled from CMS publications. Payment limits are Medicare national amounts; other payers differ. CPT codes appear as numbers only. Not legal, clinical or billing advice.