J0169 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0169 summary

J0169 is a HCPCS Level II J-code used to bill epinephrine (adrenalin), billed per 0.1 MG. 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 J0169: Adrenalin(J0169), Adrenalin, Adrenalin (Epinephrine)

Code J0169 Billing unit 0.1 MG Payment limit $0.783/unit NDC-Crosswalk 7 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 codeJ0169

DescriptorInj epinephrine (adrenalin)

Billing unit0.1 MG

Payment limit / unit$0.783

Est. ASP / unit$0.739 est.

Mapped NDCs7

Data periodQ3 2026

Last updated2026-08-20

💊 About Epinephrine DRUG GUIDE

Epinephrine is used for the emergency treatment of severe allergic reactions (Type I), including anaphylaxis.

Triggers can include insect stings or bites, foods, drugs, diagnostic substances, allergen immunotherapy, or unknown causes (idiopathic anaphylaxis) and exercise-induced anaphylaxis.

These reactions can cause life-threatening symptoms such as throat swelling, wheezing, a dangerous drop in blood pressure, hives, and vomiting.Adrenalin (injection) is also indicated to raise blood pressure in adult patients with low blood pressure caused by septic shock.

Primatene Mist (inhaler) is used for temporary relief of mild symptoms of intermittent asthma — including wheezing, chest tightness, and shortness of breath.

Read the full Epinephrine drug guide →

Clinical overview from our editorial drug guide for Epinephrine. For billing reference, see the sections above.

🧾 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

$0.783

Est. ASP / unit

$0.739 est.

Est. after 2% sequester

$0.767

HCPCS dosage

0.1 MG

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 J0169 = 0.1 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 J0169 LEAST EXPENSIVE FIRST

7 NDCs map to J0169. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.783/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
42023-0159-25	Adrenalin epinephrine 1 mg/mL INJECTION	Par	25 VIAL in 1 CARTON (42023-159-25) / 1 mL...	1 mg/mL	250	$195.75	$7.796	● Active	CMS ASP
00404-9810-01	Adrenalin epineprine 1 mg/mL INJECTION	Henry	1 VIAL, SINGLE-USE in 1 BAG (0404-9810-01)...	1 mg/mL	10	$7.83	—	● Active	CMS ASP
51662-1290-01	ADRENALIN (EPINEPHRINE) 1 mg/mL INJECTION	HF	1 mL in 1 VIAL, SINGLE-DOSE (51662-1290-1)	1 mg/mL	10	$7.83	—	● Active	CMS ASP
51662-1290-03	ADRENALIN (EPINEPHRINE) 1 mg/mL INJECTION	HF	25 POUCH in 1 CASE (51662-1290-3) / 1 mL...	1 mg/mL	250	$195.75	—	● Active	CMS ASP
24357-0011-13	Epinephrine Professional Epinephrine and Isopropyl Alcohol KIT	Focus	1 KIT in 1 CARTON (24357-011-13) * 1 mL...	—	10	$7.83	—	● Active	PDAC
71754-0001-01	EPINEPHRINE CONVENIENCE KIT 1 CONVENIENCE KITS 1 MG/1 ML	Unknown	—	—	10	$7.83	—	—	PDAC
71754-0001-05	EPINEPHRINE CONVENIENCE KIT 5 CONVENIENCE KITS 1 MG/1 ML	Unknown	—	—	10	$7.83	—	—	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 J0169 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J0169. 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 J0169
J0171	Adrenalin epinephrine inject	—	—	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J0165	EPINEPHRINE*	0.1 MG	$0.234	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J0166	EPINEPHRINE	0.1 MG	$0.669	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

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

$1.6K

Claims

184

Beneficiaries

179

Spend / beneficiary

$8.81

Spend / claim

$8.57

Trend by period

Where J0169 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #752 of 824

#747 FLUPHENAZINE DECANOA... J2680 $1.9K #748 ATIVAN* J2060 $1.8K #749 ACETAMINOPHEN(J0136) J0136 $1.7K #750 BICILLIN C-R J0558 $1.7K #751 RECOMBIVAX HB 90743 $1.7K #752 ADRENALIN(J0169) J0169 $1.6K #753 NALBUPHINE HCL J2300 $1.5K #754 NITROGLYCERIN IN D5W... J2305 $1.5K #755 AMPHADASE J3470 $1.4K #756 TIGAN J3250 $1.4K #757 AMPICILLIN-SULBACTAM... J0295 $1.3K

Total claims — #557 of 824

#552 BENEFIX J7195 193 #553 CHORIONIC GONADOTROP... J0725 191 #554 VISUDYNE J3396 190 #555 TRI MEMBRANE WRAP, P... Q4344 188 #556 POLOCAINE-MPF* J0670 185 #557 ADRENALIN(J0169) J0169 184 #558 INVEGA HAFYERA* J2427 184 #559 SUBLOCADE(Q9991) Q9991 183 #560 PROGRAF(J7521) J7521 182 #561 HYDRALAZINE HCL J0360 180 #562 AMNICORE PRO+, PER S... Q4299 176

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$1.6K	179	184	$8.81	$8.57
2025 (Q1-Q4)	$4.4K	340	359	$13.03	$12.34

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

$1.7K

Medicare paid

$1.8K

Submitted services

2,482

Denial rate

46.0%

Allowed / service

$1.29

Submitted charges

$22.7K

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 J0169

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

Epinephrine and Isopropyl Alcohol 1

NDC products by labeler

Focus Health Group 1

🔗 Related NDC directory pages

🧪 All Epinephrine And Isopropyl Alcohol NDCsIngredient 🏭 All Focus labeler NDCsLabeler 24357

🗃️ 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)

7 NDCs mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

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.

❓ J0169 billing FAQ

What is HCPCS code J0169?

J0169 is a HCPCS Level II J-code used to bill Inj epinephrine (adrenalin) under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J0169?

One unit of J0169 represents 0.1 MG. Report the number of units equal to the dose administered divided by 0.1 MG.

How many units of J0169 should I bill?

Divide the dose administered by the code's unit size (0.1 MG) 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 J0169?

The Medicare Part B payment limit is $0.783 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.767 per unit. Payment limits are revised quarterly.

Which NDCs bill under J0169?

7 NDCs currently map to J0169 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 J0169 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.

J0169 – Inj epinephrine (adrenalin) · NDC Crosswalk & Billing Units