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P9011 Blood split unit

What P9011 is

Blood, split unit

HCPCS Level II long description, CMS October 2026 file. See the P codes page for the full section.

Medicare payment for P9011 (CY2026)

This code has no Physician Fee Schedule rate: Excluded from the Physician Fee Schedule (paid under another system or not priced here). It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps P9011 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with P9011? These codes are bundled into it

P9011 is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
P9010Whole blood for transfusion1 - modifier may bypassCheck pair
P9021Red blood cells unit0 - no modifier bypassCheck pair
P9022Washed red blood cells unit0 - no modifier bypassCheck pair
P9039Rbc deglycerolized0 - no modifier bypassCheck pair

P9011 is bundled into these codes

P9011 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, P9011 is the code that denies.

Column 1 codeShort descriptionModifier indicator
P9032Platelets, irradiated1Check pair
P9033Platelets leukoreduced irrad1Check pair
P9036Platelet pheresis irradiated1Check pair
P9037Plate pheres leukoredu irrad1Check pair
P9038Rbc irradiated1Check pair
P9040Rbc leukoreduced irradiated1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.