Home › Drug Codes › Q Codes › Q9963 · GASTROGRAFIN
Updated July 1st, 2026

GASTROGRAFIN Q Code: Q9963

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

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Q4 2026 Medicare Payment Limit for Q9963, effective October 1, 2026: $0.219 per HCPCS billing unit, up 2.3% from $0.214. From CMS's final file.

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Medicare Payment Limit ?
$0.214
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
3
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Drug & Product Overview

HCPCS Descriptor High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml
HCPCS Added Date July 1, 2005
Manufacturer Multiple Manufacturers
Route of Administration Oral, Rectal
Generic Status Multi-Source; Generic
Dosage Type Single-Dose
Dosage Form Liquid | Solution

About GASTROGRAFIN

Gastrografin is a medication aligned to the HCPCS Q Code: Q9963 for billing, pricing, and reimbursement purposes in the United States. It is an Imaging/Radiopharmaceutical drug administered via the oral or rectal routes and manufactured by multiple companies.

According to CMS Drug Use Information: Drug uses not available

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00019-4816-04 Md Gastroview Liebel-Flarsheim Company LLC 750 18000 MG / 30 ML
00270-0445-35 Gastrografin Bracco Diagnostics Inc 720 19800 MG / 30 ML
00270-0445-40 Gastrografin Bracco Diagnostics Inc 1440 79200 MG / 120 ML
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GASTROGRAFIN Pricing & Reimbursement

Q9963 Private Payer Reimbursement
$0.42 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

GASTROGRAFIN Medically Unlikely Edits (MUE)

The most billing units of Q9963 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 ml.

Practitioner Office & Hospital Outpatient
240 units / day
= 240 ml per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

ml Enter a dose to see how many billing units it is and whether it is under the limit.
Not on the CMS JW / JZ list

CMS does not include Gastrografin (Q9963) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q9963. Wastage billing guide →

GASTROGRAFIN Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

CT of the Torso (Body Imaging) Computed Tomography of the Torso (Body Imaging) Radiographic Examination of Segments of the Gastrointestinal Tract
Drug Class
Radiographic Contrast Agent [EPC]X-Ray Contrast Activity [MoA]

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Frequently Asked Questions

Is there an available Gastrografin billing and coding guide?
We have not yet identified a manufacturer source of Gastrografin billing and coding information.
Are there any available Gastrografin patient assistance programs?
Our team did not identify a source for Gastrografin patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Gastrografin prescribing information?
Our team is still working to identify a prescribing information source for GASTROGRAFIN
Where can I find Gastrografin side effect information?
Our team has not yet identified a source of side effects information for GASTROGRAFIN. Please check back in a few weeks.
Does billing GASTROGRAFIN require JZ/JW wastage modifiers?
CMS does not include GASTROGRAFIN (Q9963) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q9963. For more information, visit the link below.

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