Search by Drug Name, NDC or Jcode

    Internal Navigation

    HCPCS Details

    HCPC J0875
    Short Description Injection, dalbavancin
    Long Description Injection, dalbavancin, 5 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2016-01-01
    Date Added 2016-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    57970010001 J0875 Injection, dalbavancin Dalvance DURATA PHARMACEUTICALS 5 MG 1 1 100 100
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 5 MG
    HCPCS/CPT Billing Units 0.2
    Total doses ordered
    Billing Units 0.2

    Drug Details

    • Dalbavancin injection is used to treat skin infections caused by certain types of bacteria. Dalbavancin is in a class of medications called lipoglycopeptide antibiotics. It works by killing bacteria.

    • Antibiotics such as dalbavancin will not kill viruses that can cause colds, flu, or other infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.