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J0138

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

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 10 MG/3MG $0.092/unit ASP+6%

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Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 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.
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)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
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.

📊 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)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/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.

📊 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

🗃️ 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.
For professional billing reference only — verify against the current CMS files before submitting claims.