J0138 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0138 summary

J0138 is a HCPCS Level II J-code used to bill acetaminoph 10mg/ibu 3mg, billed per 10 MG/3MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J0138: Combogesic Iv

Code J0138 Billing unit 10 MG/3MG Payment limit $0.092/unit NDC-Crosswalk 1 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ0138

DescriptorInj acetaminoph 10mg/ibu 3mg

Billing unit10 MG/3MG

Payment limit / unit$0.092

Est. ASP / unit$0.087 est.

Mapped NDCs1

Data periodQ3 2026

Last updated2026-08-20

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).

Medicare payment limit / unit

$0.092

Est. ASP / unit

$0.087 est.

Est. after 2% sequester

$0.090

HCPCS dosage

10 MG/3MG

The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0138 = 10 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J0138 WITH EST. MEDICARE PAY

1 NDC map to J0138. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.092/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00143-9150-10	COMBOGESIC IV acetaminophen and ibuprofen injection 1000 mg/100mL; 300 mg/100mL INJECTION	Hikma	10 VIAL in 1 CARTON (0143-9150-10) / 100...	1000 mg/100mL; 300 mg/100mL	1,000	$92.00	—	● Active	CMS + PDAC

NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

⚠️ Don't confuse J0138 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J0138. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J0138
J1741	Ibuprofen injection	100 MG	$3.252	Different billing unit — 100 MG vs 10 MG/3MG

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$209.95

Claims

23

Beneficiaries

22

Spend / beneficiary

$9.54

Spend / claim

$9.13

Trend by period

Where J0138 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #803 of 824

#798 LABETALOL HCL J1920 $273.36 #799 CEFUROXIME SODIUM J0697 $269.35 #800 BENTYL* J0500 $265.01 #801 CONRAY Q9961 $251.21 #802 GLYCOPYRROLATE(J1596... J1596 $240.57 #803 COMBOGESIC IV J0138 $209.95 #804 MORPHINE SULFATE(J22... J2272 $209.58 #805 NALOXONE HCL(J2312) J2312 $175.36 #806 DILTIAZEM HCL-0.9% N... J1163 $166.44 #807 ADRENALIN(J0165)* J0165 $164.81 #808 PROGESTERONE J2675 $144.09

Total claims — #771 of 824

#766 INTEGRA MATRIX** Q4108 25 #767 EPINEPHRINE J0166 24 #768 HEPAGAM B(J1573) J1573 24 #769 YUTIQ J7314 24 #770 GAMIFANT J9210 24 #771 COMBOGESIC IV J0138 23 #772 CEFAZOLIN SODIUM(J06... J0688 23 #773 DAPTOMYCIN-0.9% NACL J0874 23 #774 BREVIBLOC* J1805 23 #775 DAPTOMYCIN(J0873) J0873 22 #776 TRETTEN J7181 22

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$209.95	22	23	$9.54	$9.13
2025 (Q1-Q4)	$9.4K	404	410	$23.20	$22.86

Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.

Allowed charges

$7.00

Medicare paid

$5.49

Submitted services

80

Submitted charges

$7.00

Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗺️ Where J0138 is utilized

⏳

The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.

📊 What bills under J0138

J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.

NDC products by ingredient

acetaminophen and ibuprofen inject... 1

NDC products by labeler

Hikma Pharmaceuticals USA Inc. 1

🔗 Related NDC directory pages

🧪 All Acetaminophen And Ibuprofen Injection NDCsIngredient 🏭 All Hikma labeler NDCsLabeler 00143 📚 All Nonsteroidal Anti-inflammatory Drug NDCsDrug class

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.

HCPCS code & descriptor

CMS HCPCS Level II code file

Not available in current dataset

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Q3 2026 · as of 2026-08-20

NDC ↔ HCPCS crosswalk

CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)

1 NDC mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

Not available for mapped NDCs

Utilization & spend

CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners

Latest data year 2026

Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J0138 billing FAQ

What is HCPCS code J0138?

J0138 is a HCPCS Level II J-code used to bill Inj acetaminoph 10mg/ibu 3mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J0138?

One unit of J0138 represents 10 MG/3MG. Report the number of units equal to the dose administered divided by 10 MG/3MG.

How many units of J0138 should I bill?

Divide the dose administered by the code's unit size (10 MG/3MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.

How much does Medicare pay for J0138?

The Medicare Part B payment limit is $0.092 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.090 per unit. Payment limits are revised quarterly.

Which NDCs bill under J0138?

1 NDC currently map to J0138 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.

Does a crosswalk mean J0138 is covered?

No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.

J0138 – Inj acetaminoph 10mg/ibu 3mg · NDC Crosswalk & Billing Units