How many Q2043 billing units are in a package of Provenge?

CMS lists 1 billing units per package, depending on the NDC, where one unit is per infusion (minimum 50 million cells). Units to report are based on the dose given, not the package.

No. Q2043 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.

Provenge HCPCS Code Q2043 — Billing Units & NDCs

In short

Provenge is billed under HCPCS Q2043. One billing unit is per infusion (minimum 50 million cells). CMS's crosswalk lists 1 Provenge NDC under this code.

Q2043 code details

Reference

Q2043: HCPCS Level II drug codeBilling unit: per infusion (minimum 50 million cells)
Labelers: Dendreon Pharmaceuticals LLC

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$55,663.131

Perper infusion (minimum 50 million cells)

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

Provenge units and claim line

Enter the dose given to get the Q2043 units and the NDC line for the CMS-1500 and the 837P.

HCPCS units

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the units to build the claim line.

Provenge 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.

Provenge NDCs in the CMS ASP crosswalk
NDC (11-digit)	HCPCS	Labeler	Package	Billing units per package
30237-8900-06	Q2043	Dendreon Pharmaceuticals LLC	250	1

Provenge: common questions

What is the HCPCS code for Provenge?: Provenge is billed under HCPCS Q2043. One billing unit is per infusion (minimum 50 million cells). CMS's crosswalk lists 1 Provenge NDC under this code.
How many Q2043 billing units are in a package of Provenge?: CMS lists 1 billing units per package, depending on the NDC, where one unit is per infusion (minimum 50 million cells). Units to report are based on the dose given, not the package.
Is Q2043 a CPT code?: No. Q2043 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.

Provenge HCPCS Code