A9579
A9579 – Gad-base mr contrast nos,1ml · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 17 NDCs crosswalked per 1 ML $1.435/unit ASP+6%
📋 A9579 summary
A9579 is a HCPCS Level II J-code used to bill Gad-base mr contrast nos,1ml, billed per 1 ML. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with A9579: Prohance, Omniscan, Gadoteridol
Code A9579
Billing unit 1 ML Payment limit $1.435/unit NDC-Crosswalk 17
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeA9579
DescriptorGad-base mr contrast nos,1ml
Billing unit1 ML
Payment limit / unit$1.435
Est. ASP / unit$1.354 est.
Mapped NDCs17
Data periodQ3 2026
Last updated2026-09-20
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$1.435
Est. ASP / unit
$1.354 est.
Est. after 2% sequester
$1.406
HCPCS dosage
1 ML
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of A9579 = 1 ml. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under A9579 WITH EST. MEDICARE PAY
17 NDCs map to A9579. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.435/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00270-1111-01 | ProHance gadoteridol 279.3 mg/mL INJECTION, SOLUTION | Bracco | 5 VIAL, SINGLE-DOSE in 1 BOX (0270-1111-01... | 279.3 mg/mL | 50 | $71.75 | — | ● Active | CMS ASP |
| 00270-1111-02 | ProHance gadoteridol 279.3 mg/mL INJECTION, SOLUTION | Bracco | 5 VIAL, SINGLE-DOSE in 1 BOX (0270-1111-02... | 279.3 mg/mL | 75 | $107.63 | — | ● Active | CMS ASP |
| 00270-1111-03 | ProHance gadoteridol 279.3 mg/mL INJECTION, SOLUTION | Bracco | 5 VIAL, SINGLE-DOSE in 1 BOX (0270-1111-03... | 279.3 mg/mL | 100 | $143.50 | — | ● Active | CMS ASP |
| 00270-1111-04 | ProHance gadoteridol 279.3 mg/mL INJECTION, SOLUTION | Bracco | 5 VIAL, SINGLE-DOSE in 1 BOX (0270-1111-04... | 279.3 mg/mL | 25 | $35.88 | — | ● Active | CMS ASP |
| 00270-1111-85 | ProHance gadoteridol 279.3 mg/mL INJECTION, SOLUTION | Bracco | 5 VIAL, PHARMACY BULK PACKAGE in 1 BOX (02... | 279.3 mg/mL | 500 | $717.50 | — | ● Active | CMS ASP |
| 00407-0690-05 | Omniscan | GE | — | — | 50 | $71.75 | — | — | CMS ASP |
| 00407-0690-10 | OMNISCAN gadodiamide 287 mg/mL INJECTION | GE | 10 VIAL in 1 BOX (0407-0690-10) / 10 mL i... | 287 mg/mL | 100 | $143.50 | — | ● Active | CMS ASP |
| 00407-0690-12 | Omniscan | GE | — | — | 100 | $143.50 | — | — | CMS ASP |
| 00407-0690-15 | OMNISCAN gadodiamide 287 mg/mL INJECTION | GE | 10 VIAL in 1 BOX (0407-0690-15) / 15 mL i... | 287 mg/mL | 150 | $215.25 | — | ● Active | CMS ASP |
| 00407-0690-17 | Omniscan | GE | — | — | 150 | $215.25 | — | — | CMS ASP |
| 00407-0690-20 | OMNISCAN gadodiamide 287 mg/mL INJECTION | GE | 10 VIAL in 1 BOX (0407-0690-20) / 20 mL i... | 287 mg/mL | 200 | $287.00 | — | ● Active | CMS ASP |
| 00407-0690-22 | Omniscan | GE | — | — | 200 | $287.00 | — | — | CMS ASP |
| 00407-0690-70 | Omniscan | GE | — | — | 1,000 | $1,435.00 | — | — | CMS ASP |
| 70436-0121-31 | GADOTERIDOL 279.3 mg/mL INJECTION | Slate | 5 VIAL, SINGLE-DOSE in 1 CARTON (70436-121... | 279.3 mg/mL | 25 | $35.88 | — | ● Active | CMS ASP |
| 70436-0121-33 | GADOTERIDOL 279.3 mg/mL INJECTION | Slate | 5 VIAL, SINGLE-DOSE in 1 CARTON (70436-121... | 279.3 mg/mL | 50 | $71.75 | — | ● Active | CMS ASP |
| 70436-0121-34 | GADOTERIDOL 279.3 mg/mL INJECTION | Slate | 5 VIAL, SINGLE-DOSE in 1 CARTON (70436-121... | 279.3 mg/mL | 75 | $107.63 | — | ● Active | CMS ASP |
| 70436-0121-35 | GADOTERIDOL 279.3 mg/mL INJECTION | Slate | 5 VIAL, SINGLE-DOSE in 1 CARTON (70436-121... | 279.3 mg/mL | 100 | $143.50 | — | ● Active | CMS ASP |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$262K
Claims
10,762
Beneficiaries
10,413
Spend / beneficiary
$25.17
Spend / claim
$24.35
Trend by period
Where A9579 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #504 of 824
#499
AMNIO QUAD-CORE, PER... Q4294
$270.2K
#500
DAXXIFY J0589
$269.7K
#501
ALBUMIN (HUMAN)* P9041
$267.7K
#502
YUTIQ J7314
$263.2K
#503
MITOMYCIN J9280
$262.7K
#504
GADOTERIDOL* A9579
$262K
#505
BEIZRAY-ALBUMIN* J9174
$258.2K
#506
CYCLOPHOSPHAMIDE(J90... J9071
$255.9K
#507
ERTAPENEM J1335
$254.7K
#508
SURGRAFT TL, PER SQ... Q4263
$246.1K
#509
CAMPTOSAR* J9206
$245.5K
Total claims — #160 of 824
#155
FENTANYL CITRATE J3010
11,877
#156
TRILURON J7332
11,689
#157
AKYNZEO J1454
11,028
#158
RUXIENCE Q5119
11,016
#159
RAPAMUNE* J7520
10,934
#160
GADOTERIDOL* A9579
10,762
#161
LIBTAYO J9119
10,576
#162
CAMPTOSAR* J9206
10,330
#163
ZARXIO Q5101
10,231
#164
CUBICIN RF* J0878
9,691
#165
TRIESENCE J3300
9,687
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $262K | 10,413 | 10,762 | $25.17 | $24.35 |
| 2025 (Q1-Q4) | $1.14M | 41,989 | 46,793 | $27.15 | $24.36 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$1.08M
Medicare paid
$832K
Submitted services
788,567
Denial rate
8.4%
Allowed / service
$1.50
Submitted charges
$8.35M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where A9579 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 664,794 services across 46 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Not available in current dataset
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
17 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ A9579 billing FAQ
What is HCPCS code A9579?
A9579 is a HCPCS Level II J-code used to bill Gad-base mr contrast nos,1ml under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for A9579?
One unit of A9579 represents 1 ML. Report the number of units equal to the dose administered divided by 1 ML.
How many units of A9579 should I bill?
Divide the dose administered by the code's unit size (1 ML) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for A9579?
The Medicare Part B payment limit is $1.435 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.406 per unit. Payment limits are revised quarterly.
Which NDCs bill under A9579?
17 NDCs currently map to A9579 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean A9579 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.