J0517
J0517 – Injection, benralizumab, 1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 3 NDCs crosswalked per 1 MG $165.563/unit ASP+6%
📋 J0517 summary
J0517 is a HCPCS Level II J-code used to bill benralizumab, 1 mg, billed per 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 J0517: Fasenra Pen*, Fasenra
Code J0517
Billing unit 1 MG Payment limit $165.563/unit NDC-Crosswalk 3
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 codeJ0517
DescriptorInjection, benralizumab, 1 mg
Billing unit1 MG
Payment limit / unit$165.563
Est. ASP / unit$156.192 est.
Mapped NDCs3
Data periodQ3 2026
Last updated2026-08-20
💊 About Benralizumab Injection DRUG GUIDE
Fasenra (benralizumab) is used for three conditions driven by abnormally high levels of eosinophils (a type of white blood cell that causes inflammation).
It is approved as an add-on maintenance treatment for severe asthma with an eosinophilic pattern in adults and children aged 6 and older, for eosinophilic granulomatosis with polyangiitis (EGPA) in adults, and for hypereosinophilic syndrome (HES) in adults and children aged 12 and older without an identifiable non-blood-related cause.Important: Fasenra is not a rescue medication.
It will not relieve sudden asthma symptoms or a severe asthma attack.
Always keep your quick-relief inhaler available.
Clinical overview from our editorial drug guide for Benralizumab Injection. 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
$165.563
Est. ASP / unit
$156.192 est.
Est. after 2% sequester
$162.252
HCPCS dosage
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.
Full HCPCS code details (official CMS record)
Long descriptionInjection, benralizumab, 1 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2019-01-01
Date added2019-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0517 = 1 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 J0517 WITH EST. MEDICARE PAY
3 NDCs map to J0517. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($165.563/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00310-1730-30 | FASENRA Benralizumab 30 mg/mL INJECTION, SOLUTION | AstraZeneca | 1 SYRINGE, GLASS in 1 CARTON (0310-1730-30... | 30 mg/mL | 30 | $4,966.89 | — | ● Active | CMS + PDAC |
| 00310-1745-01 | FASENRA Benralizumab 10 mg/.5mL INJECTION, SOLUTION | AstraZeneca | 1 CARTRIDGE in 1 CARTON (0310-1745-01) /... | 10 mg/.5mL | 10 | $1,655.63 | — | ● Active | CMS ASP |
| 00310-1830-30 | FASENRA Benralizumab 30 mg/mL INJECTION, SOLUTION | AstraZeneca | 1 CARTRIDGE in 1 CARTON (0310-1830-30) /... | 30 mg/mL | 30 | $4,966.89 | — | ● 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
$57.38M
Claims
12,132
Beneficiaries
7,871
Spend / beneficiary
$7,290.67
Spend / claim
$4,730.04
Trend by period
Where J0517 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #60 of 824
#55
ELAHERE J9063
$65.45M
#56
OCTAGAM J1568
$60.65M
#57
TECVAYLI J9380
$60.55M
#58
KISUNLA J0175
$60.44M
#59
HEMLIBRA J7170
$58.54M
#60
FASENRA PEN* J0517
$57.38M
#61
GAZYVA J9301
$54.46M
#62
LEQEMBI J0174
$54.32M
#63
OPDIVO QVANTIG J9289
$53.38M
#64
IMDELLTRA J9026
$52.93M
#65
SOLIRIS(J1299) J1299
$52.79M
Total claims — #151 of 824
#146
IPRATROPIUM BROMIDE J7644
12,953
#147
ERTAPENEM J1335
12,875
#148
ENGERIX-B ADULT(9074... 90746
12,582
#149
PYRIDOXINE HCL J3415
12,475
#150
FULPHILA Q5108
12,305
#151
FASENRA PEN* J0517
12,132
#152
FASLODEX* J9395
12,034
#153
COSENTYX J3247
12,030
#154
VEGZELMA Q5129
12,004
#155
FENTANYL CITRATE J3010
11,877
#156
TRILURON J7332
11,689
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $57.38M | 7,871 | 12,132 | $7,290.67 | $4,730.04 |
| 2025 (Q1-Q4) | $251.3M | 10,424 | 53,039 | $24,108.15 | $4,738.09 |
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
$161.36M
Medicare paid
$125.22M
Submitted services
1,015,224
Denial rate
2.5%
Allowed / service
$163.07
Submitted charges
$400.32M
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 J0517 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 326,267 services across 34 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J0517
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
NDC products by labeler
🗃️ 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
Loaded
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)
3 NDCs 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.
❓ J0517 billing FAQ
What is HCPCS code J0517?
J0517 is a HCPCS Level II J-code used to bill Injection, benralizumab, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0517?
One unit of J0517 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J0517 should I bill?
Divide the dose administered by the code's unit size (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 J0517?
The Medicare Part B payment limit is $165.563 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $162.252 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0517?
3 NDCs currently map to J0517 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 J0517 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.