Codes in this range
85 of the 85 codes carry a published October 2026 payment limit; the remaining codes are priced by contractors or carry a limit of zero in the file.
| Code | Descriptor | Unit | Limit | MUE | Col-2 pairs | Articles |
|---|---|---|---|---|---|---|
| Q0138 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd | 1 MG | $0.331 | 510 | — | — |
| Q0139 | Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (for esrd | 1 MG | $0.331 | 510 | — | — |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a | 1 MG | $0.016 | 0 | — | — |
| Q0166 | Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, | 1 MG | $0.774 | 0 | — | — |
| Q0167 | Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a | 2.5 MG | $2.092 | 0 | — | — |
| Q0224 | Injection, pemivibart, for the pre-exposure prophylaxis only, for certain | 4500 MG | $7,615.20 | 1 | — | — |
| Q0234 | Injection, tocilizumab-bavi, for hospitalized adult patients with covid-19 who | 1 MG | $6.327 | — | — | — |
| Q0237 | Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who | 1 MG | $4.92 | — | — | — |
| Q0238 | Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who | 1 MG | $5.581 | — | — | — |
| Q0249 | Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years | 1 MG | $7.569 | 1600 | — | — |
| Q2041 | Axicabtagene ciloleucel, up to 200 million autologous anti-cd19 car positive | UP TO 200 MILLION CAR T CELLS | $577,943.258 | — | — | — |
| Q2042 | Tisagenlecleucel, up to 600 million car-positive viable t cells, including | up to 600 million CAR-positive viable T cells | $626,315.834 | — | — | — |
| Q2043 | Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with | Per infusion (minimum 50 million cells) | $55,663.131 | 1 | 1 | yes |
| Q2050 | Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg | 10 MG | $97.823 | 14 | — | — |
| Q2053 | Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive | UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS | $532,352.741 | — | — | — |
| Q2054 | Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive | Up to 110 million CAR-positive viable T cells, per therapeutic dose | $589,846.771 | — | — | — |
| Q2055 | Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen | UP TO 510 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CELLS | $575,850.465 | — | — | — |
| Q2056 | Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation | up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells | $594,112.255 | — | — | — |
| Q2057 | Afamitresgene autoleucel, including leukapheresis and dose preparation | PER THERAPEUTIC DOSE | $813,967.375 | 1 | — | — |
| Q2058 | Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, | Per Therapeutic Dose | $293,725.702 | 1 | — | — |
| Q4081 | Injection, epoetin alfa, 100 units (for esrd on dialysis) | 100 UNITS | $0.667 | 100 | — | yes |
| Q5098 | Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg | 1 MG | $9.27 | 520 | — | — |
| Q5099 | Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg | 1 MG | $2.89 | 520 | — | — |
| Q5100 | Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg | 1 MG | $3.08 | 520 | — | — |
| Q5101 | Injection, filgrastim-sndz, biosimilar, (zarxio), 1 microgram | 1 MCG | $0.338 | 1500 | — | yes |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | 10 MG | $28.456 | 150 | — | yes |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | 10 MG | $25.649 | 150 | — | yes |
| Q5105 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for esrd on dialysis), | 100 UNITS | $0.817 | 100 | — | yes |
| Q5106 | Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 | 1000 UNITS | $8.171 | 60 | — | yes |
| Q5107 | Injection, bevacizumab-awwb, biosimilar, (mvasi), 10 mg | 10 MG | $28.294 | 230 | — | yes |
| Q5108 | Injection, pegfilgrastim-jmdb (fulphila), biosimilar, 0.5 mg | 0.5 MG | $55.964 | 12 | — | yes |
| Q5110 | Injection, filgrastim-aafi, biosimilar, (nivestym), 1 microgram | 1 MCG | $0.329 | 1500 | — | yes |
| Q5111 | Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg | 0.5 MG | $128.967 | 12 | — | yes |
| Q5112 | Injection, trastuzumab-dttb, biosimilar, (ontruzant), 10 mg | 10 MG | $32.791 | 120 | — | — |
| Q5113 | Injection, trastuzumab-pkrb, biosimilar, (herzuma), 10 mg | 10 MG | $55.295 | 120 | — | — |
| Q5114 | Injection, trastuzumab-dkst, biosimilar, (ogivri), 10 mg | 10 MG | $29.507 | 120 | — | — |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | 10 MG | $35.988 | 150 | — | yes |
| Q5116 | Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg | 10 MG | $11.271 | 120 | — | — |
| Q5117 | Injection, trastuzumab-anns, biosimilar, (kanjinti), 10 mg | 10 MG | $63.871 | 120 | — | — |
| Q5118 | Injection, bevacizumab-bvzr, biosimilar, (zirabev), 10 mg | 10 MG | $25.939 | 230 | — | yes |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 10 MG | $5.792 | 150 | — | yes |
| Q5120 | Injection, pegfilgrastim-bmez (ziextenzo), biosimilar, 0.5 mg | 0.5 MG | $302.247 | 12 | — | yes |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | 10 MG | $34.686 | 150 | — | yes |
| Q5122 | Injection, pegfilgrastim-apgf (nyvepria), biosimilar, 0.5 mg | 0.5 MG | $141.289 | 12 | — | yes |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | 10 MG | $21.083 | 150 | — | yes |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | 0.1 MG | $249.493 | 10 | — | yes |
| Q5125 | Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram | 1 MCG | $0.308 | 1800 | — | yes |
| Q5126 | Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg | 10 MG | $79.982 | 230 | — | yes |
| Q5127 | Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg | 0.5 MG | $163.948 | 12 | — | yes |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | 0.1 MG | $81.13 | 10 | — | yes |
| Q5129 | Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg | 10 MG | $21.139 | 230 | — | yes |
| Q5130 | Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg | 0.5 MG | $94.292 | 12 | — | yes |
| Q5133 | Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg | 1 MG | $4.706 | 1200 | — | — |
| Q5134 | Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg | 1 MG | $24.397 | 300 | — | — |
| Q5135 | Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg | 1 MG | $4.37 | 1200 | — | — |
| Q5136 | Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg | 1 MG | $26.991 | 120 | — | yes |
| Q5138 | Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg | 1 MG | $2.273 | 520 | — | — |
| Q5146 | Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg | 10 MG | $30.255 | 120 | — | — |
| Q5147 | Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg | 1 MG | $763.376 | 4 | — | yes |
| Q5148 | Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram | 1 MCG | $1.026 | 1500 | — | yes |
| Q5151 | Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg | 2 MG | $31.547 | 600 | — | yes |
| Q5152 | Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg | 2 MG | $40.412 | 600 | — | yes |
| Q5156 | Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg | 1 MG | $3.098 | — | — | — |
| Q5157 | Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg | 1 MG | $24.002 | — | — | yes |
| Q5158 | Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg | 1 MG | $28.702 | — | — | yes |
| Q5160 | Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg | 10 MG | $82.139 | 230 | — | yes |
| Q5161 | Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg | 1 MG | $27.509 | — | — | — |
| Q5162 | Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg | 1 MG | $15.336 | — | — | yes |
| Q5167 | Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg | 1 MG | $7.681 | — | — | yes |
| Q5168 | Injection, ranibizumab-leyk (nufymco), biosimilar, 0.1 mg | 0.1 MG | $26.384 | — | — | yes |
| Q5169 | Injection, pegfilgrastim-unne (armlupeg), biosimilar, 0.5 mg | 0.5 MG | $519.481 | — | — | yes |
| Q9950 | Injection, sulfur hexafluoride lipid microspheres, per ml | 1 ML | $18.052 | 5 | — | yes |
| Q9956 | Injection, octafluoropropane microspheres, per ml | 1 ML | $40.323 | 9 | — | yes |
| Q9957 | Injection, perflutren lipid microspheres, per ml | 1 ML | $40.323 | 3 | — | yes |
| Q9958 | High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml | 1 ML | $0.08 | 300 | 4 | — |
| Q9961 | High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml | 1 ML | $0.205 | 200 | 2 | — |
| Q9963 | High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml | 1 ML | $0.219 | 240 | — | — |
| Q9965 | Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml | 1 ML | $1.787 | 250 | 7 | — |
| Q9966 | Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 1 ML | $0.421 | 250 | 6 | — |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1 ML | $0.186 | 300 | 5 | — |
| Q9991 | Injection, buprenorphine extended-release (sublocade), less than or equal to | Less than or equal to 100 MG | $2,060.132 | 1 | — | — |
| Q9992 | Injection, buprenorphine extended-release (sublocade), greater than 100 mg | Greater than 100 MG | $2,060.132 | 1 | — | — |
| Q9997 | Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg | 1 MG | $8.591 | 520 | — | — |
| Q9998 | Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg | 1 MG | $10.48 | 520 | — | — |
| Q9999 | Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg | 1 MG | $13.246 | 520 | — | — |
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 temporary codes (q codes)?
85 codes in this range carry an ASP payment limit in the October 2026 file; 53 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.
- Medicare Part B Drug Payment Limit File, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csvSHA-256 508fba376a29e099…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
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.