HCPCS A9585 Medicare ASP Payment Limit 2026
Injection, gadobutrol, 0.1 ml
Medicare's Part B payment limit for HCPCS A9585 is $0.235 per billing unit (0.1 ml) in the October 2026 ASP file, down 14.5% from $0.275 in 2025.
- Per 0.1 ml
- $0.235
- vs. 2025
- -14.5%
- Commercial national avg.
- $0.357
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| Code | Month | Year | Payment Limit | Description |
|---|---|---|---|---|
| A9585 - HCPCS | Jan | 2025 | $0.28 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Apr | 2025 | $0.26 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Jul | 2025 | $0.26 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Oct | 2025 | $0.28 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Jan | 2026 | $0.28 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Apr | 2026 | $0.30 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Jul | 2026 | $0.26 | Injection, gadobutrol, 0.1 ml |
| A9585 - HCPCS | Oct | 2026 | $0.24 | Injection, gadobutrol, 0.1 ml |
A9585 payment limit by quarter
Each row is one quarterly CMS ASP file. Change is against the quarter before.
| Quarter | Payment limit per 0.1 ml | Change |
|---|---|---|
| October 2026 | $0.235 | -10.3% |
| July 2026 | $0.262 | -13.8% |
| April 2026 | $0.304 | +10.5% |
| January 2026 | $0.275 | No change |
| October 2025 | $0.275 | +4.6% |
| July 2025 | $0.263 | -0.4% |
| April 2025 | $0.264 | -5.0% |
| January 2025 | $0.278 | - |
The payment limit is Medicare's allowed amount per billing unit: the average sales price plus the statutory add-on. Medicare generally pays 80% of it after the Part B deductible, and the patient's coinsurance covers the rest. CMS recalculates it every quarter from manufacturer-reported sales.
A9585: Medicare vs. commercial national average
The commercial national average for A9585, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $0.357 per 0.1 ml, 152% of Medicare's $0.235.
- BCBS $0.436
- UnitedHealthcare $0.298
- Aetna $0.399
- Cigna $0.294
A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for A9585 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its current ASP payment limit per billing unit. Payers may bill the drug in a different unit, so compare the two with care.
Nearby codes
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See what state Medicaid programs pay for A9585
50 state Medicaid agencies publish their own physician fee schedule. The A9585 page shows real published rates for several of them free, with effective dates and official sources.
17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.
Methodology
Rates are sourced from CMS Part B Drug Average Sales Price (ASP) pricing files, published quarterly. Each HCPCS payment limit reflects the calculated ASP plus the statutory add-on for that quarter.
View CMS Part B ASP Pricing Files