How much does Medicare pay for HCPCS Q9957?

Medicare allowed an average of $41.40 per service and paid $32.16 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $179.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q9957?

Injection, perflutren lipid microspheres, per ml. It was billed 72,795 times to 38,592 Medicare beneficiaries by 1,184 providers in 2024.

Does Q9957 pay differently in an office than a hospital?

Yes. The allowed amount averaged $41.40 in an office setting and $41.80 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills Q9957 most?

Cardiology, with 54,719 services from 894 clinicians. Next are Interventional Cardiology, Internal Medicine, Advanced Heart Failure and Transplant Cardiology.

HCPCS Q9957

Injection, perflutren lipid microspheres, per ml

$41.40Medicare-allowed amount per service, averaged across 72,795 services

Providers submitted

$179.35

Asking price, not received

Medicare allowed

$41.40

The fee schedule figure

Medicare paid

$32.16

Balance is patient coinsurance

Providers submitted an average of $179.35 for this code and Medicare allowed $41.40 — 4.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $32.16 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $41.40
Hospital / facility: $41.80

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 72,716 services were billed in an office setting and 79 in a facility.

Services: 72,795
Beneficiaries: 38,592
Providers billing it: 1,184
Total allowed: $3,013,713

What Medicare pays for HCPCS Q9957

Across 72,795 services billed by 1,184 providers to 38,592 beneficiaries, Medicare allowed an average of $41.40 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills Q9957

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	54,719	29,454	$41.43	894
Interventional Cardiology	10,395	5,398	$41.27	175
Internal Medicine	2,969	1,384	$41.47	40
Advanced Heart Failure and Transplant Cardiology	1,463	784	$41.46	22
Clinical Cardiac Electrophysiology	701	350	$41.51	17
Nurse Practitioner	633	247	$40.83	9
Independent Diagnostic Testing Facility (IDTF)	577	281	$40.64	2
Family Practice	534	181	$41.76	5
Physician Assistant	210	103	$41.35	5
Nuclear Medicine	199	165	$41.39	6
Diagnostic Radiology	162	81	$42.10	3
Interventional Radiology	84	84	$40.57	2
Hospitalist	58	29	$42.11	1
Thoracic Surgery	42	21	$41.81	1
Critical Care (Intensivists)	38	19	$41.28	1

Q9957 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	12,401	$41.60	$32.57	98
New York	6,003	$41.47	$32.83	102
North Carolina	5,639	$41.39	$32.06	120
Illinois	4,700	$41.21	$32.43	79
Wisconsin	3,754	$41.15	$31.93	48
Texas	3,569	$41.51	$32.73	72
Georgia	3,498	$41.41	$32.62	51
Arizona	2,936	$41.36	$32.45	25
Michigan	2,676	$41.31	$32.46	53
Alabama	2,185	$41.65	$32.17	25
Tennessee	2,066	$41.24	$32.90	26
Missouri	1,843	$41.34	$32.18	19
Pennsylvania	1,801	$41.41	$32.06	42
Virginia	1,591	$41.17	$32.45	32
Colorado	1,566	$41.59	$32.70	25
Nebraska	1,366	$41.62	$32.35	20
Florida	1,328	$41.60	$32.55	38
Indiana	1,282	$41.46	$32.39	31
South Carolina	1,257	$41.05	$32.13	22
Washington	1,231	$41.39	$32.24	38
Minnesota	1,178	$41.33	$32.22	30
New Jersey	1,166	$41.45	$32.21	33
Utah	1,086	$41.39	$32.56	14
Ohio	1,059	$40.75	$33.00	21
Iowa	991	$41.62	$32.12	25
Montana	931	$41.54	$32.19	6
Alaska	634	$41.38	$32.62	16
Kansas	608	$41.63	$32.37	16
Oregon	608	$40.02	$31.00	14
Idaho	500	$41.63	$31.61	5
Massachusetts	335	$42.04	$33.01	8
Nevada	172	$41.49	$32.45	6
Maryland	153	$40.46	$32.57	4
Oklahoma	97	$40.44	$32.96	3
Connecticut	91	$42.02	$30.30	3
Mississippi	88	$41.22	$32.84	4
Louisiana	72	$41.92	$32.74	1
Maine	66	$40.49	$33.29	1
Wyoming	56	$41.05	$31.35	2
District of Columbia	55	$40.01	$33.25	1
West Virginia	51	$41.01	$30.60	2
Kentucky	40	$41.12	$31.08	1
New Mexico	38	$40.72	$32.44	1
South Dakota	28	$40.27	$32.08	1

Related codes

Q9967Low osmolar contrast material$0.13
Q9966Low osmolar contrast material$0.36
Q9965Low osmolar contrast material$1.37
Q9958High osmolar contrast material$0.08
Q9968Injection, non-radioactive, non-contrast, visualization adjunct (e.g.,$7.59
Q9956Injection, octafluoropropane microspheres, per ml$41.27
Q9969Tc-99m from non-highly enriched uranium source$14.28
Q9950Injection, sulfur hexafluoride lipid microspheres, per ml$18.49
Q9961High osmolar contrast material$0.28
Q9983Florbetaben f18$3080.60
Q9963High osmolar contrast material$0.21
Q9982Flutemetamol f18$3525.03

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.