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Q9997

Q9997 – Ustekinumab-ttwe iv inj 1 mg · NDC Crosswalk & Billing Units

HCPCS Level II Q-code · Medicare Part B drug billing

Q-code ● 2 NDCs crosswalked per 1 MG $8.552/unit ASP+6%

This page is curated, coded, and maintained by Dr. Brian Staiger, PharmD

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 Q9997 summary

Q9997 is a HCPCS Level II Q-code used to bill Ustekinumab-ttwe iv inj 1 mg, billed per 1 MG. 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 Q9997: Pyzchiva, Ustekinumab-Ttwe

Code Q9997 Billing unit 1 MG Payment limit $8.552/unit NDC-Crosswalk 2 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 codeQ9997

DescriptorUstekinumab-ttwe iv inj 1 mg

Billing unit1 MG

Payment limit / unit$8.552

Est. ASP / unit$8.068 est.

Mapped NDCs2

Data periodQ3 2026

Last updated2026-08-20

🧾 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

$8.552

Est. ASP / unit

$8.068 est.

Est. after 2% sequester

$8.381

HCPCS dosage

1 MG

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 Q9997 = 1 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

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 Q9997 WITH EST. MEDICARE PAY

2 NDCs map to Q9997. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($8.552/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
61314-0654-94	PYZCHIVA ustekinumab-ttwe 130 mg/26mL INJECTION, SOLUTION	SANDOZ	1 VIAL, SINGLE-USE in 1 CARTON (61314-654-...	130 mg/26mL	130	$1,111.76	—	● Active	CMS ASP
82009-0163-94	USTEKINUMAB-TTWE 130 mg/26mL INJECTION, SOLUTION	Quallent	1 VIAL, SINGLE-USE in 1 CARTON (82009-163-...	130 mg/26mL	130	$1,111.76	—	● 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.

⚠️ Don't confuse Q9997 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with Q9997. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from Q9997
J3357	Ustekinumab sub cu inj, 1 mg	—	—	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J3358	Ustekinumab, iv inject, 1 mg	1 MG	$11.356	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
Q5100	USTEKINUMAB-KFCE	1 MG	$3.290	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
Q5099	USTEKINUMAB-STBA	1 MG	$3.075	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

🗺️ Where Q9997 is utilized

⏳

The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.

🗃️ 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 2026-08-20

NDC ↔ HCPCS crosswalk

CMS ASP NDC-HCPCS crosswalk

2 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

No reportable utilization

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.

❓ Q9997 billing FAQ

What is HCPCS code Q9997?

Q9997 is a HCPCS Level II Q-code used to bill Ustekinumab-ttwe iv inj 1 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for Q9997?

One unit of Q9997 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.

How many units of Q9997 should I bill?

Divide the dose administered by the code's unit size (1 MG) 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 Q9997?

The Medicare Part B payment limit is $8.552 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $8.381 per unit. Payment limits are revised quarterly.

Which NDCs bill under Q9997?

2 NDCs currently map to Q9997 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 Q9997 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.