HCPCS drug code · CMS crosswalk
Definity HCPCS Code
In short
Definity is billed under HCPCS Q9957 — Injection, perflutren lipid microspheres, per ml. One billing unit is 1 ml. CMS's crosswalk lists 2 Definity NDCs under this code.
Reference
- Q9957
- Injection, perflutren lipid microspheres, per mlBilling unit: 1 ml
- Labelers
- Lantheus Medical Imaging, Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$40.323
Per1 ml
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Definity units and claim line
Enter the dose given to get the Q9957 units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
Definity NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 11994-0011-04 | Q9957 | Lantheus Medical Imaging, Inc. | 4 × 2 | 8 |
| 11994-0011-16 | Q9957 | Lantheus Medical Imaging, Inc. | 16 × 2 | 32 |
Definity: common questions
- What is the HCPCS code for Definity?
- Definity is billed under HCPCS Q9957 — Injection, perflutren lipid microspheres, per ml. One billing unit is 1 ml. CMS's crosswalk lists 2 Definity NDCs under this code.
- How many Q9957 billing units are in a package of Definity?
- CMS lists 8 to 32 billing units per package, depending on the NDC, where one unit is 1 ml. Units to report are based on the dose given, not the package.
- Is Q9957 a CPT code?
- No. Q9957 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.