Products billed under this code include Iodixanol, Iomeron, Iopamidol, Isovue-200, Isovue-250, Isovue-M-200, Omnipaque 240, Visipaque 270.
Payment limit per 1 ML, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Iodixanol | FreseniUS Kabi USA, LLC | 65219-0381-10 | 1000 | $421.00 |
| Iodixanol | FreseniUS Kabi USA, LLC | 65219-0381-50 | 1500 | $631.50 |
| Iomeron | Bracco Diagnostics Inc. | 00270-7250-10 | 5600 | $2,357.60 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0124-52 | 200 | $84.20 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0124-82 | 100 | $42.10 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0125-82 | 500 | $210.50 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0211-80 | 50 | $21.05 |
| Isovue-200 | Bracco Diagnostics Inc. | 00270-1314-15 | 2000 | $842.00 |
| Isovue-250 | Bracco Diagnostics Inc. | 00270-1317-02 | 1000 | $421.00 |
| Isovue-M-200 | Bracco Diagnostics Inc. | 00270-1411-11 | 100 | $42.10 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-10 | 100 | $42.10 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-20 | 200 | $84.20 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-30 | 500 | $210.50 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-33 | 1000 | $421.00 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-34 | 1500 | $631.50 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-35 | 2000 | $842.00 |
| Omnipaque 240 | GE Healthcare Inc. | 00407-1412-38 | 500 | $210.50 |
| Visipaque 270 | GE Healthcare Inc. | 00407-2222-16 | 500 | $210.50 |
| Visipaque 270 | GE Healthcare Inc. | 00407-2222-17 | 1000 | $421.00 |
| Visipaque 270 | GE Healthcare Inc. | 00407-2222-19 | 1500 | $631.50 |
| Visipaque 270 | GE Healthcare Inc. | 00407-2222-21 | 2000 | $842.00 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.421 | −$0.014 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted September 17, 2026 |
| 3Q26 | $0.435 | +$0.001 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 2Q26 | $0.434 | +$0.033 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 1Q26 | $0.401 | −$0.049 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 4Q25 | $0.45 | +$0.005 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted September 8, 2026 |
| 3Q25 | $0.445 | +$0.038 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted March 10, 2026 |
| 2Q25 | $0.407 | +$0.002 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted March 10, 2026 |
| 1Q25 | $0.405 | +$0.026 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted December 19, 2025 |
| 4Q24 | $0.379 | +$0.03 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 11, 2025 |
| 3Q24 | $0.349 | −$0.039 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 11, 2025 |
| 2Q24 | $0.388 | +$0.015 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted March 11, 2025 |
| 1Q24 | $0.373 | −$0.034 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted December 19, 2024 |
| 4Q23 | $0.407 | +$0.038 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted October 10, 2024 |
| 3Q23 | $0.369 | −$0.137 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 5, 2024 |
| 2Q23 | $0.506 | +$0.03 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted February 23, 2024 |
| 1Q23 | $0.476 | +$0.155 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted December 6, 2023 |
| 4Q22 | $0.321 | −$0.019 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 22, 2023 |
| 3Q22 | $0.34 | −$0.008 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 9, 2023 |
| 2Q22 | $0.348 | +$0.004 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted December 14, 2022 |
| 1Q22 | $0.344 | +$0.007 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 8, 2022 |
| 4Q21 | $0.337 | +$0.013 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 2, 2022 |
| 3Q21 | $0.324 | +$0.006 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted June 2, 2022 |
| 2Q21 | $0.318 | −$0.008 | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted March 1, 2022 |
| 1Q21 | $0.326 | – | 1 ML | Locm 200-299mg/ml iodine,1ml | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
