Bracco Diagnostics

GASTROGRAFIN - Cost

Last Updated: April 1st, 2024

HCPCS:

Q9963

HCPCS Code Descriptor:

High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml

Medicare Payment Limit:

The GASTROGRAFIN Medicare Payment Limit is $0.217

Average Sale Price:

GASTROGRAFIN ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The GASTROGRAFIN Medicare Co-insurance percentage is 20%. GASTROGRAFIN's Medicare Co-insurance amount is $0.04 per HCPCS unit.

APC Code:

The Gastrografin APC Code is: not available

APC Payment Limit:

The APC Payment Limit for GASTROGRAFIN is not available.

Gastrografin Cost Information:

GASTROGRAFIN, manufactured by Bracco Diagnostics, is aligned to HCPCS Q9963 and became effective on July 1, 2005. There are three NDCs mapped to Q Code: Q9963 with potential discrepancies found amongst all of these alignments. Pricing between AWP and WAC have been constant since 2020. ASP experienced a couple adjustments but has remained somewhat level.

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Gastrografin’s wholesale acquisition cost (WAC) information was last updated on:
January 8, 2019
Gastrografin’s average wholesale price (AWP) information was last updated on:
January 8, 2019

Gastrografin Cost Graph: