Products billed under this code include Iodixanol, Iomeron, Iopamidol, Ioversol Injection 678 MG/ML, Ioversol Injection 741 MG/ML, Isovue-300, Isovue-370, Isovue-M-300, Omnipaque 300, Omnipaque 300 (Novaplus), Omnipaque 350, Omnipaque 350 (Novaplus), Optiray 320, Optiray 350, Ultravist 300, Ultravist 370, Visipaque 320.
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 | 65219-0383-05 | 500 | $93.00 |
| Iodixanol | FreseniUS Kabi USA, LLC | 65219-0383-10 | 1000 | $186.00 |
| Iodixanol | FreseniUS Kabi USA, LLC | 65219-0383-50 | 1500 | $279.00 |
| Iodixanol | FreseniUS Kabi USA, LLC | 65219-0383-70 | 2000 | $372.00 |
| Iodixanol | Slate Run Pharmaceuticals | 70436-0126-82 | 150 | $27.90 |
| Iomeron | Bracco Diagnostics Inc. | 00270-7300-10 | 5600 | $1,041.60 |
| Iomeron | Bracco Diagnostics Inc. | 00270-7300-20 | 2000 | $372.00 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0127-82 | 1000 | $186.00 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0219-52 | 300 | $55.80 |
| Iopamidol | Slate Run Pharmaceuticals | 70436-0219-62 | 500 | $93.00 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Iopamidol | Slate Run Pharmaceuticals | 70436-0219-82 | 1000 | $186.00 |
| Ioversol Injection 678 MG/ML | Liebel-Flarsheim Company LLC | 00019-1323-65 | 3000 | $558.00 |
| Ioversol Injection 741 MG/ML | Liebel-Flarsheim Company LLC | 00019-1333-65 | 3000 | $558.00 |
| Isovue-300 | Bracco Diagnostics Inc. | 00270-1315-25 | 300 | $55.80 |
| Isovue-300 | Bracco Diagnostics Inc. | 00270-1315-35 | 1000 | $186.00 |
| Isovue-300 | Bracco Diagnostics Inc. | 00270-1315-45 | 2000 | $372.00 |
| Isovue-300 | Bracco Diagnostics Inc. | 00270-1315-95 | 3000 | $558.00 |
| Isovue-370 | Bracco Diagnostics Inc. | 00270-1316-35 | 1000 | $186.00 |
| Isovue-370 | Bracco Diagnostics Inc. | 00270-1316-45 | 2000 | $372.00 |
| Isovue-370 | Bracco Diagnostics Inc. | 00270-1316-95 | 3000 | $558.00 |
| Isovue-M-300 | Bracco Diagnostics Inc. | 00270-1412-15 | 150 | $27.90 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-10 | 100 | $18.60 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-53 | 1250 | $232.50 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-59 | 300 | $55.80 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-61 | 500 | $93.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-62 | 750 | $139.50 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-63 | 1000 | $186.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-65 | 1500 | $279.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-66 | 2000 | $372.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-68 | 5000 | $930.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-69 | 1250 | $232.50 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-72 | 5000 | $930.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-86 | 500 | $93.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-87 | 1000 | $186.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-88 | 1500 | $279.00 |
| Omnipaque 300 | GE Healthcare Inc. | 00407-1413-89 | 5000 | $930.00 |
| Omnipaque 300 (Novaplus) | GE Healthcare Inc. | 00407-1413-48 | 5000 | $930.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-72 | 5000 | $930.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-76 | 1250 | $232.50 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-82 | 500 | $93.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-84 | 1000 | $186.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-85 | 1250 | $232.50 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-86 | 1500 | $279.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-87 | 2000 | $372.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-88 | 5000 | $930.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-89 | 500 | $93.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-90 | 750 | $139.50 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-91 | 1000 | $186.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-93 | 1500 | $279.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-94 | 2000 | $372.00 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-95 | 1250 | $232.50 |
| Omnipaque 350 | GE Healthcare Inc. | 00407-1414-98 | 5000 | $930.00 |
| Omnipaque 350 (Novaplus) | GE Healthcare Inc. | 00407-1414-48 | 5000 | $930.00 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-06 | 1250 | $232.50 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-11 | 1200 | $223.20 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-16 | 1800 | $334.80 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-21 | 2400 | $446.40 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-52 | 1000 | $186.00 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-78 | 1000 | $186.00 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-87 | 2500 | $465.00 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-90 | 2000 | $372.00 |
| Optiray 320 | Liebel-Flarsheim Company LLC | 00019-1323-95 | 1500 | $279.00 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-06 | 1250 | $232.50 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-11 | 1200 | $223.20 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-16 | 1800 | $334.80 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-21 | 2400 | $446.40 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-78 | 1000 | $186.00 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-87 | 2500 | $465.00 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-90 | 2000 | $372.00 |
| Optiray 350 | Liebel-Flarsheim Company LLC | 00019-1333-95 | 1500 | $279.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-05 | 500 | $93.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-10 | 1000 | $186.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-12 | 1250 | $232.50 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-15 | 1500 | $279.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-21 | 2000 | $372.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-23 | 2000 | $372.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-58 | 4000 | $744.00 |
| Ultravist 300 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0344-65 | 4000 | $744.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-05 | 500 | $93.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-10 | 1000 | $186.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-15 | 1500 | $279.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-20 | 2000 | $372.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-25 | 2500 | $465.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-28 | 2000 | $372.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-58 | 4000 | $744.00 |
| Ultravist 370 | Bayer HealthCare Pharmaceuticals Inc. | 50419-0346-65 | 4000 | $744.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-16 | 500 | $93.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-17 | 1000 | $186.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-19 | 1500 | $279.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-21 | 2000 | $372.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-23 | 5000 | $930.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-62 | 500 | $93.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-64 | 1000 | $186.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-66 | 1500 | $279.00 |
| Visipaque 320 | GE Healthcare Inc. | 00407-2223-67 | 2000 | $372.00 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.186 | +$0.031 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted September 17, 2026 |
| 3Q26 | $0.155 | +$0.001 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 2Q26 | $0.154 | +$0.005 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 1Q26 | $0.149 | −$0.003 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted September 15, 2026 |
| 4Q25 | $0.152 | +$0.001 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted September 8, 2026 |
| 3Q25 | $0.151 | +$0.008 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted March 10, 2026 |
| 2Q25 | $0.143 | −$0.001 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted March 10, 2026 |
| 1Q25 | $0.144 | +$0.003 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted December 19, 2025 |
| 4Q24 | $0.141 | +$0.006 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 11, 2025 |
| 3Q24 | $0.135 | −$0.002 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 11, 2025 |
| 2Q24 | $0.137 | +$0.019 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted March 11, 2025 |
| 1Q24 | $0.118 | −$0.013 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted December 19, 2024 |
| 4Q23 | $0.131 | +$0.005 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted October 10, 2024 |
| 3Q23 | $0.126 | −$0.043 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 5, 2024 |
| 2Q23 | $0.169 | −$0.005 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted February 23, 2024 |
| 1Q23 | $0.174 | +$0.058 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted December 6, 2023 |
| 4Q22 | $0.116 | $0.00 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 22, 2023 |
| 3Q22 | $0.116 | −$0.003 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 9, 2023 |
| 2Q22 | $0.119 | −$0.002 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted December 14, 2022 |
| 1Q22 | $0.121 | −$0.002 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 8, 2022 |
| 4Q21 | $0.123 | +$0.002 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 2, 2022 |
| 3Q21 | $0.121 | +$0.008 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted June 2, 2022 |
| 2Q21 | $0.113 | −$0.001 | 1 ML | Locm 300-399mg/ml iodine,1ml | v1, posted March 1, 2022 |
| 1Q21 | $0.114 | – | 1 ML | Locm 300-399mg/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.
