Home / Medicare fees / Q2043

`Q2043` Sipuleucel-t auto cd54+

What Q2043 is

Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion

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

Medicare payment for Q2043 (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.

Medically Unlikely Edit (MUE)

Medicare caps Q2043 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with Q2043? These codes are bundled into it

Q2043 is a Column 1 code in 171 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 code	Short description	Modifier indicator
`0213T`	Njx paravert w/us cer/thor	0 - no modifier bypass	Check pair
`0216T`	Njx paravert w/us lumb/sac	0 - no modifier bypass	Check pair
`0596T`	Temp fml iu vlv-pmp 1st insj	1 - modifier may bypass	Check pair
`0597T`	Temp fml iu valve-pmp rplcmt	1 - modifier may bypass	Check pair
`0692T`	Therapeutic ultrafiltration	0 - no modifier bypass	Check pair
`0903T`	Ecg alg 12 lead reduced i&r	1 - modifier may bypass	Check pair
`0904T`	Ecg alg 12 ld rdcd trcg only	1 - modifier may bypass	Check pair
`0905T`	Ecg alg 12 ld rdcd i&r only	1 - modifier may bypass	Check pair
`36000`	Place needle in vein	1 - modifier may bypass	Check pair
`36400`	Vnpnxr<3yrs phy/qhp fem/jug	1 - modifier may bypass	Check pair
`36405`	Vnpnxr<3yrs phy/qhp scalp vn	1 - modifier may bypass	Check pair
`36406`	Vnpnxr<3yrs phy/qhp other vn	1 - modifier may bypass	Check pair
`36410`	Vnpnxr 3yr/> phy/qhp dx/ther	1 - modifier may bypass	Check pair
`36420`	Venipuncture cutdown < 1 yr	1 - modifier may bypass	Check pair
`36425`	Venipuncture cutdown 1 yr/>	1 - modifier may bypass	Check pair
`36430`	Transfusion bld/bld compnt	1 - modifier may bypass	Check pair
`36440`	Bld push tfuj 2 yr/<	1 - modifier may bypass	Check pair
`36512`	Apheresis rbc	0 - no modifier bypass	Check pair
`36513`	Apheresis platelets	0 - no modifier bypass	Check pair
`36514`	Apheresis plasma	0 - no modifier bypass	Check pair
`36516`	Apheresis immunoads slctv	0 - no modifier bypass	Check pair
`36600`	Withdrawal of arterial blood	1 - modifier may bypass	Check pair
`36640`	Insertion catheter artery	1 - modifier may bypass	Check pair
`38206`	Harvest auto stem cells	0 - no modifier bypass	Check pair
`38210`	T-cell depletion of harvest	0 - no modifier bypass	Check pair
`38211`	Tumor cell deplete of harvst	0 - no modifier bypass	Check pair
`38212`	Rbc depletion of harvest	0 - no modifier bypass	Check pair
`38213`	Platelet deplete of harvest	0 - no modifier bypass	Check pair
`38214`	Volume deplete of harvest	0 - no modifier bypass	Check pair
`38215`	Harvest stem cell concentrte	0 - no modifier bypass	Check pair

Showing 30 of 171 column 2 codes. Use the pair checker for any specific combination.

Q2043 is bundled into these codes

Q2043 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, Q2043 is the code that denies.

Column 1 code	Short description	Modifier indicator
`36522`	Photopheresis	1	Check 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.