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    HCPCS Details

    HCPC J9217
    Short Description Leuprolide acetate suspnsion
    Long Description Leuprolide acetate (for depot suspension), 7.5 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code YY
    BETOS2 code O1D
    Action code N
    Type of service 1
    Effective date 1997-01-01
    Date Added 1991-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00074334603 J9217 Leuprolide acetate suspnsion Lupron Depot-3 month 22.5mg kit ABBVIE US, LLC 7.5 MG 1 1 3 3
    00074347303 J9217 Leuprolide acetate suspnsion LUPRON DEPOT 6-MONTH, 45MG ABBVIE US, LLC 7.5 MG 1 1 6 6
    00074364203 J9217 Leuprolide acetate suspnsion Lupron Depot 7.5 mg kit ABBVIE US, LLC 7.5 MG 1 1 1 1
    00074368303 J9217 Leuprolide acetate suspnsion LUPRON DEPOT 4-MONTH, 30MG ABBVIE US, LLC 7.5 MG 1 1 4 4
    62935022305 J9217 Leuprolide acetate suspnsion Eligard TOLMAR 7.5 MG 1 1 3 3
    62935030330 J9217 Leuprolide acetate suspnsion Eligard TOLMAR 7.5 MG 1 1 4 4
    62935045345 J9217 Leuprolide acetate suspnsion Eligard TOLMAR 7.5 MG 1 1 6 6
    62935046150 J9217 Leuprolide acetate suspnsion ELIGARD TOLMAR PHARMACEUTICALS 7.5 MG 1 1 6 6
    62935075375 J9217 Leuprolide acetate suspnsion Eligard TOLMAR 7.5 MG 1 1 1 1
    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 7.5 MG
    HCPCS/CPT Billing Units 0.14285714285714
    Total doses ordered
    Billing Units 0.14285714285714