P9046 — Infusion, albumin (human), 25%, 20 ml
P9046 is a HCPCS Level II code for infusion, albumin (human), 25%, 20 ml. It belongs to the Pathology and Laboratory Services section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of P9046 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 25 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 40 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for P9046
- Long descriptor
- Infusion, albumin (human), 25%, 20 ml
- Short descriptor
- Albumin (human), 25%, 20 ml
- Added
- January 1, 2002
- BETOS
- Y2
- Pricing indicator
- 52 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Reasonable charge.
Codes adjacent to P9046
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If P9046 is not quite right, the correct code is very often within a few positions of it.
- P9037Platelets, pheresis, leukocytes reduced, irradiated, each unit
- P9038Red blood cells, irradiated, each unit
- P9039Red blood cells, deglycerolized, each unit
- P9040Red blood cells, leukocytes reduced, irradiated, each unit
- P9041Infusion, albumin (human), 5%, 50 ml
- P9043Infusion, plasma protein fraction (human), 5%, 50 ml
- P9044Plasma, cryoprecipitate reduced, each unit
- P9045Infusion, albumin (human), 5%, 250 ml
- P9047Infusion, albumin (human), 25%, 50 ml
- P9048Infusion, plasma protein fraction (human), 5%, 250 ml
- P9050Granulocytes, pheresis, each unit
- P9051Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit
- P9052Platelets, hla-matched leukocytes reduced, apheresis/pheresis, each unit
- P9053Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit
- P9054Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit
- P9055Platelets, leukocytes reduced, cmv-negative, apheresis/pheresis, each unit
Questions about P9046
What is HCPCS code P9046?
P9046 is a HCPCS Level II code for infusion, albumin (human), 25%, 20 ml. It sits in the Pathology and Laboratory Services section.
Does Medicare cover P9046?
The CMS HCPCS file marks P9046 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is P9046 paid under the physician fee schedule?
P9046 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.