Q9965
Q9965 – Low osmolar contrast material, 100-199 mg/ml iodine concentration, per m · NDC Crosswalk & Billing Units
HCPCS Level II Q-code · Medicare Part B drug billing
Q-code
● 3 NDCs crosswalked per 1 ML $0.750/unit ASP+6%
📋 Q9965 summary
Q9965 is a HCPCS Level II Q-code used to bill Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml, 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 Q9965: Omnipaque
Code Q9965
Billing unit 1 ML Payment limit $0.750/unit NDC-Crosswalk 3
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 codeQ9965
DescriptorLow osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
Billing unit1 ML
Payment limit / unit$0.750
Est. ASP / unit$0.708 est.
Mapped NDCs3
Data periodQ3 2026
Last updated2026-08-20
💊 About Iohexol DRUG GUIDE
Iohexol is not a treatment for a disease — it's a contrast agent, a special liquid given before or during imaging tests to make blood vessels, organs, and other structures show up more clearly on scans.
It's used across a wide range of imaging procedures in both adults and children.These procedures include spinal imaging (myelography), CT scans of the head and body, heart and blood vessel studies, gastrointestinal imaging, joint imaging, and examinations of body cavities such as the bladder, uterus, and bile ducts.
Clinical overview from our editorial drug guide for Iohexol. For billing reference, see the sections above.
🧾 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
$0.750
Est. ASP / unit
$0.708 est.
Est. after 2% sequester
$0.735
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.
Full HCPCS code details (official CMS record)
Long descriptionLow osmolar contrast material, 100-199 mg/ml iodine concentration, per ml
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service4
BETOS-2I1E
ASC payment group—
Action codeN — No maintenance this year
Effective date2008-01-01
Date added2008-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of Q9965 = 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 Q9965 WITH EST. MEDICARE PAY
3 NDCs map to Q9965. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.750/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00407-1401-52 | OMNIPAQUE Iohexol 140 mg/mL INJECTION, SOLUTION | GE | 10 BOTTLE, PLASTIC in 1 BOX (0407-1401-52)... | 140 mg/mL | 500 | $375.00 | — | ● Active | CMS ASP |
| 00407-1411-10 | OMNIPAQUE Iohexol 180 mg/mL INJECTION, SOLUTION | GE | 10 VIAL, GLASS in 1 BOX (0407-1411-10) /... | 180 mg/mL | 100 | $75.00 | — | ● Active | CMS ASP |
| 00407-1411-20 | Omnipaque 180 | GE | — | — | 200 | $150.00 | — | — | 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
$559.4K
Claims
15,067
Beneficiaries
7,429
Spend / beneficiary
$75.30
Spend / claim
$37.13
Trend by period
Where Q9965 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #430 of 824
#425
NUZYRA J0121
$578.1K
#426
ACETYLCYSTEINE J7608
$575.2K
#427
MYLOTARG J9203
$570.9K
#428
GRAFIX PLUS, PER SQ... Q4304
$566.2K
#429
CAPECITABINE* J8522
$562.7K
#430
OMNIPAQUE Q9965
$559.4K
#431
PRIALT J2278
$553.3K
#432
MILRINONE IN 5% DEXT... J2260
$551.1K
#433
RAPAMUNE* J7520
$539.9K
#434
CORIFACT J7180
$532.3K
#435
CARNITOR* J1955
$526.4K
Total claims — #134 of 824
#129
GEL-ONE J7326
16,189
#130
KYPROLIS J9047
15,969
#131
BORTEZOMIB(J9041)* J9041
15,380
#132
IRON SUCROSE* J1756
15,220
#133
REBLOZYL J0896
15,092
#134
OMNIPAQUE Q9965
15,067
#135
DEFINITY RT* Q9957
14,931
#136
TRUXIMA Q5115
13,822
#137
OXALIPLATIN J9263
13,733
#138
MVASI Q5107
13,685
#139
ACTIVASE* J2997
13,490
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) | $559.4K | 7,429 | 15,067 | $75.30 | $37.13 |
| 2025 (Q1-Q4) | $2.89M | 23,562 | 69,367 | $122.56 | $41.63 |
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
$2.96M
Medicare paid
$2.42M
Submitted services
2,659,214
Denial rate
2.6%
Allowed / service
$1.14
Submitted charges
$6.23M
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 Q9965 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 2,137,868 services across 36 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
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
3 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.
❓ Q9965 billing FAQ
What is HCPCS code Q9965?
Q9965 is a HCPCS Level II Q-code used to bill Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for Q9965?
One unit of Q9965 represents 1 ML. Report the number of units equal to the dose administered divided by 1 ML.
How many units of Q9965 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 Q9965?
The Medicare Part B payment limit is $0.750 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.735 per unit. Payment limits are revised quarterly.
Which NDCs bill under Q9965?
3 NDCs currently map to Q9965 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 Q9965 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.