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    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q9957-perflutren-lipid-microspheres-injection-contrast-ultrasound
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    HCPCS Level II Q9957: Perflutren Lipid Microspheres Injection, per ml

    HCPCS Level II code Q9957 describes billing for an injection of perflutren lipid microspheres, reported per milliliter, used as an ultrasound contrast agent for enhanced echocardiography; service type is contrast agent administration and the typical site of service is hospital outpatient departments, imaging centers, or physician offices where echocardiographic or ultrasound contrast-enhanced studies are performed.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with a history of ischemic heart disease and chronic shortness of breath is referred for a transthoracic echocardiogram with contrast to better define left ventricular endocardial borders and assess wall motion during an outpatient cardiology visit. The patient arrives at the outpatient imaging center; nursing documents allergies and IV access is established. Perflutren lipid microspheres (Q9957) are prepared by pharmacy or trained technicians and drawn into a syringe per manufacturer dosing guidance. The sonographer performs baseline two-dimensional and Doppler imaging, then injects the contrast agent intravenously while acquiring contrast-enhanced images to delineate endocardial borders, evaluate ejection fraction, and assess for regional wall motion abnormalities. The study is interpreted by a cardiologist. Typical documentation includes indication, amount of Q9957 administered (ml), IV site, any immediate adverse reaction, imaging findings, and the cardiologist’s interpretation. Typical site of service is an outpatient hospital-based or freestanding echocardiography/imaging center; the service type is an ultrasound contrast agent injection used as an adjunct to diagnostic echocardiography.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    93306Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, complete, with Doppler echocardiographyPrimary diagnostic study for which Q9957 is used as an adjunct to improve endocardial border definition and wall motion assessment.
    93308Echocardiography, transthoracic, real-time with image documentation (2D), with contrast agent during rest or stress studyDirectly linked: describes performance of contrast-enhanced transthoracic echocardiography where Q9957 is the contrast agent administered.
    93350Contrast echocardiography for left ventricular opacification, per injectionDescribes administration of contrast specifically for left ventricular opacification; used alongside billing for the agent Q9957.
    93000Electrocardiogram, routine ECG with at least 12 leads; includes interpretation and reportOften performed immediately before or during echocardiography to correlate rhythm during image acquisition.
    93010Interpretation and report only of electrocardiogram when performed separately from the ECG recordingUsed if ECG recording performed elsewhere and only the interpretation is billed in the workflow.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RC0000XCardiovascular Disease PhysicianAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    225200000XPhysical Therapy Assistant(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
    2085B0100XBody Imaging PhysicianA Radiology doctor of Osteopathy that specializes in Body Imaging.
    163WA2000XAdministrator Registered NurseNursing Service Providers · Registered Nurse
    3336N0007XNuclear PharmacyA pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures.
    207WX0107XRetina Specialist (Ophthalmology) PhysicianAn ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
    1223P0300XPeriodonticsThat specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the tee…

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV)blue cross blue shield - louisiana2026-09-15

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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