J0578 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0578 summary

J0578 is a HCPCS Level II J-code used to bill brixadi, more than 7 day, billed per Greater than 7 days and up to 28 days of therapy. 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 J0578: Brixadi(J0578), Brixadi

Code J0578 Billing unit Greater than 7 days and up to 28 days of therapy Payment limit $1,722.305/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 codeJ0578

DescriptorInj brixadi, more than 7 day

Billing unitGreater than 7 days and up to 28 days of therapy

Payment limit / unit$1,722.305

Est. ASP / unit$1,624.816 est.

Mapped NDCs3

Data periodQ3 2026

Last updated2026-08-20

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🧾 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

$1,722.305

Est. ASP / unit

$1,624.816 est.

Est. after 2% sequester

$1,687.859

HCPCS dosage

Greater than 7 days and up to 28 days of therapy

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 J0578 = 7 days. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (days) 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 J0578 WITH EST. MEDICARE PAY

3 NDCs map to J0578. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1,722.305/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
58284-0228-01	BRIXADI BUPRENORPHINE 128 mg/.36mL INJECTION	Braeburn	1 SYRINGE, GLASS in 1 CARTON (58284-228-01...	128 mg/.36mL	1	$1,722.31	—	● Active	CMS + PDAC
58284-0264-01	BRIXADI BUPRENORPHINE 64 mg/.18mL INJECTION	Braeburn	1 SYRINGE, GLASS in 1 CARTON (58284-264-01...	64 mg/.18mL	1	$1,722.31	—	● Active	CMS + PDAC
58284-0296-01	BRIXADI BUPRENORPHINE 96 mg/.27mL INJECTION	Braeburn	1 SYRINGE, GLASS in 1 CARTON (58284-296-01...	96 mg/.27mL	1	$1,722.31	—	● 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 J0578 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J0578. 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 J0578
Q9991	Buprenorph xr 100 mg or less	Less than or equal to 100 MG	$2,068.155	Different billing unit — Less than or equal to 100 MG vs Greater than 7 days and up to 28 days of therapy
Q9992	Buprenorphine xr over 100 mg	Greater than 100 MG	$2,068.155	Different billing unit — Greater than 100 MG vs Greater than 7 days and up to 28 days of therapy
J0577	BUPRENORPHINE	Less than or equal to 7 days of therapy	$430.576	Different billing unit — Less than or equal to 7 days of therapy vs Greater than 7 days and up to 28 days of therapy
J0592	Buprenorphine hydrochloride	0.1 MG	$4.474	Different billing unit — 0.1 MG vs Greater than 7 days and up to 28 days of therapy

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

$220.9K

Claims

160

Beneficiaries

84

Spend / beneficiary

$2,629.64

Spend / claim

$1,380.56

Trend by period

Where J0578 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #516 of 824

#511 CEFTRIAXONE J0696 $239.8K #512 KHAPZORY J0642 $235.8K #513 CYCLOPHOSPHAMIDE(J85... J8530 $233.2K #514 LEUKINE J2820 $227.5K #515 OPTISON Q9956 $225.5K #516 BRIXADI(J0578) J0578 $220.9K #517 XWRAP DUAL, PER SQ C... Q4358 $220.2K #518 CYANOCOBALAMIN INJEC... J3420 $219.2K #519 ALBUKED-25(P9046)* P9046 $215K #520 PRIMATRIX** Q4110 $215K #521 PEMETREXED DISODIUM(... J9294 $212.3K

Total claims — #577 of 824

#572 AMNIPLY, PER SQ CM** Q4249 169 #573 YEZTUGO(J0752) J0752 165 #574 NITROGLYCERIN IN D5W... J2305 164 #575 PRIALT J2278 163 #576 AXOLOTL DUALGRAFT, P... Q4332 161 #577 BRIXADI(J0578) J0578 160 #578 GASTROGRAFIN* Q9963 159 #579 ONPATTRO J0222 157 #580 VONVENDI J7179 157 #581 CARVYKTI Q2056 156 #582 GANCICLOVIR SODIUM J1570 154

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$220.9K	84	160	$2,629.64	$1,380.56
2025 (Q1-Q4)	$584.4K	110	466	$5,312.80	$1,254.09

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

$50.9K

Medicare paid

$77.5K

Submitted services

875

Denial rate

89.0%

Allowed / service

$529.90

Submitted charges

$161.7K

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 J0578

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

BUPRENORPHINE 3

NDC products by labeler

Braeburn Inc. 3

🔗 Related NDC directory pages

🧪 All Buprenorphine NDCsIngredient 🏭 All Braeburn labeler NDCsLabeler 58284 📚 All Partial Opioid Agonist 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)

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.

❓ J0578 billing FAQ

What is HCPCS code J0578?

J0578 is a HCPCS Level II J-code used to bill Inj brixadi, more than 7 day under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J0578?

One unit of J0578 represents Greater than 7 days and up to 28 days of therapy. Report the number of units equal to the dose administered divided by Greater than 7 days and up to 28 days of therapy.

How many units of J0578 should I bill?

Divide the dose administered by the code's unit size (Greater than 7 days and up to 28 days of therapy) 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 J0578?

The Medicare Part B payment limit is $1,722.305 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1,687.859 per unit. Payment limits are revised quarterly.

Which NDCs bill under J0578?

3 NDCs currently map to J0578 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 J0578 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.

J0578 – Inj brixadi, more than 7 day · NDC Crosswalk & Billing Units