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J0558

J0558 – Injection, penicillin g benzathine and penicillin g procaine, 100,000 un · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 3 NDCs crosswalked per 100,000 UNITS $19.523/unit ASP+6%

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

📋 J0558 summary

J0558 is a HCPCS Level II J-code used to bill penicillin g benzathine and penicillin g procaine, 100,000 units, billed per 100,000 UNITS. 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 J0558: Bicillin C-R, Bicillin Cr

Code J0558 Billing unit 100,000 UNITS Payment limit $19.523/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 codeJ0558
DescriptorInjection, penicillin g benzathine and penicillin g procaine, 100,000 units
Billing unit100,000 UNITS
Payment limit / unit$19.523
Est. ASP / unit$18.418 est.
Mapped NDCs3
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
$19.523
Est. ASP / unit
$18.418 est.
Est. after 2% sequester
$19.133
HCPCS dosage
100,000 UNITS
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, penicillin g benzathine and penicillin g procaine, 100,000 units
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 added2011-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0558 = 1 units. 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 J0558 WITH EST. MEDICARE PAY

3 NDCs map to J0558. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($19.523/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
60793-0600-10 BICILLIN CR penicillin G benzathine and penicillin G procaine 600000 [iU]/2mL; 600000 [iU]/2mL INJECTION, SUSPENSION Pfizer 10 SYRINGE in 1 PACKAGE (60793-600-10) /... 600000 [iU]/2mL; 600000 [iU]/2mL 120 $2,342.76 — ● Active CMS ASP
60793-0601-10 BICILLIN CR penicillin G benzathine and penicillin G procaine 600000 [iU]/2mL; 600000 [iU]/2mL INJECTION, SUSPENSION Pfizer 10 SYRINGE in 1 PACKAGE (60793-601-10) /... 600000 [iU]/2mL; 600000 [iU]/2mL 120 $2,342.76 — ● Active CMS ASP
60793-0602-10 BICILLIN C-R 900/300 penicillin G benzathine and penicillin G procaine 900000 [iU]/2mL; 300000 [iU]/2mL INJECTION, SUSPENSION Pfizer 10 SYRINGE in 1 PACKAGE (60793-602-10) /... 900000 [iU]/2mL; 300000 [iU]/2mL 120 $2,342.76 — ● Active CMS ASP
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
$1.7K
Claims
13
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$131.42
Trend by period
Where J0558 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #750 of 824
#745 NAFCILLIN SODIUM J2290 $2K #746 AZACTAM* J0457 $2K #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
Total claims — #812 of 824
#807 CLINDAMYCIN-0.9% NAC... J0737 14 #808 COAGADEX J7175 14 #809 PROGRAF(J7525)* J7525 14 #810 CLOFARABINE* J9027 14 #811 ONCASPAR J9266 14 #812 BICILLIN C-R J0558 13 #813 ZINPLAVA J0565 13 #814 PELLOGRAFT, PER SQ C... Q4320 13 #815 RETACRIT(Q5105) Q5105 13 #816 ACETAMINOPHEN(J0134) J0134 12 #817 POSACONAZOLE J1837 12

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $1.7K — 13 — $131.42
2025 (Q1-Q4) $5.2K 56 74 $93.48 $70.74
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
$3.1K
Medicare paid
$2.8K
Submitted services
1,027
Denial rate
76.5%
Allowed / service
$12.93
Submitted charges
$52.9K
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.

🗃️ 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
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.

❓ J0558 billing FAQ

What is HCPCS code J0558?
J0558 is a HCPCS Level II J-code used to bill Injection, penicillin g benzathine and penicillin g procaine, 100,000 units under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0558?
One unit of J0558 represents 100,000 UNITS. Report the number of units equal to the dose administered divided by 100,000 UNITS.
How many units of J0558 should I bill?
Divide the dose administered by the code's unit size (100,000 UNITS) 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 J0558?
The Medicare Part B payment limit is $19.523 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $19.133 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0558?
3 NDCs currently map to J0558 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 J0558 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.