J0616
J0616 – Inj metoprolol tartrate 1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 14 NDCs crosswalked per 1 MG $0.155/unit ASP+6%
📋 J0616 summary
J0616 is a HCPCS Level II J-code used to bill metoprolol tartrate 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 J0616: Metoprolol
Code J0616
Billing unit 1 MG Payment limit $0.155/unit NDC-Crosswalk 14
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 codeJ0616
DescriptorInj metoprolol tartrate 1 mg
Billing unit1 MG
Payment limit / unit$0.155
Est. ASP / unit$0.146 est.
Mapped NDCs14
Data periodQ3 2026
Last updated2026-08-20
💊 About Metoprolol DRUG GUIDE
Metoprolol is used to treat several heart and blood pressure conditions.
Metoprolol succinate extended-release tablets (including Toprol-XL) are approved for high blood pressure, angina pectoris (chest pain from the heart), and heart failure.
Metoprolol tartrate tablets (including Lopressor) are approved for high blood pressure, angina, and — when used alongside intravenous metoprolol — to reduce the risk of cardiovascular death after a definite or suspected heart attack.Metoprolol tartrate injection (intravenous form) is used in hemodynamically stable patients with a definite or suspected acute heart attack to reduce cardiovascular death, and is followed by oral metoprolol therapy.
Lowering blood pressure with metoprolol reduces the risk of strokes and heart attacks.
Clinical overview from our editorial drug guide for Metoprolol. 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
$0.155
Est. ASP / unit
$0.146 est.
Est. after 2% sequester
$0.152
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.
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0616 = 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 J0616 WITH EST. MEDICARE PAY
14 NDCs map to J0616. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.155/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00143-9660-10 | Metoprolol Tartrate Metoroprolol 5 mg/5mL INJECTION, SOLUTION | Hikma | 10 VIAL in 1 CARTON (0143-9660-10) / 5 mL... | 5 mg/5mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 00143-9873-25 | Metoprolol Tartrate 5 mg/5mL INJECTION, SOLUTION | Hikma | 25 VIAL in 1 CARTON (0143-9873-25) / 5 mL... | 5 mg/5mL | 125 | $19.38 | — | ● Active | CMS ASP |
| 00409-1778-05 | Metoprolol Tartrate 1 mg/mL INJECTION, SOLUTION | Hospira, | 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-177... | 1 mg/mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 00409-2016-10 | Metoprolol Tartrate 1 mg/mL INJECTION, SOLUTION | Hospira, | 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-201... | 1 mg/mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 25021-0303-05 | Metoprolol Tartrate 1 mg/mL INJECTION, SOLUTION | Sagent | 10 VIAL in 1 CARTON (25021-303-05) / 5 mL... | 1 mg/mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 36000-0033-10 | Metoprolol 5 mg/5mL INJECTION | Baxter | 10 VIAL in 1 CARTON (36000-033-10) / 5 mL... | 5 mg/5mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 51662-1365-01 | METOPROLOL TARTRATE 5 mg/5mL INJECTION, SOLUTION | HF | 5 mL in 1 VIAL (51662-1365-1) | 5 mg/5mL | 5 | $0.78 | — | ● Active | CMS ASP |
| 51662-1478-01 | Metoprolol Tartrate | HF | — | — | 5 | $0.78 | — | — | CMS ASP |
| 51662-1478-03 | METOPROLOL TARTRATE 1 mg/mL INJECTION, SOLUTION | HF | 10 POUCH in 1 CASE (51662-1478-3) / 1 VIA... | 1 mg/mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 63323-0660-05 | Metoprolol 5 mg/5mL INJECTION, SOLUTION | Fresenius | 10 VIAL in 1 TRAY (63323-660-05) / 5 mL i... | 5 mg/5mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 72266-0122-10 | Metoprolol Tartrate 5 mg/5mL INJECTION, SOLUTION | FOSUN | 10 VIAL, SINGLE-DOSE in 1 CARTON (72266-12... | 5 mg/5mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 72266-0122-25 | Metoprolol Tartrate 5 mg/5mL INJECTION, SOLUTION | FOSUN | 25 VIAL, SINGLE-DOSE in 1 CARTON (72266-12... | 5 mg/5mL | 125 | $19.38 | — | ● Active | CMS ASP |
| 72572-0420-10 | Metoprolol Tartrate Metoroprolol 5 mg/5mL INJECTION, SOLUTION | Civica, | 10 VIAL in 1 CARTON (72572-420-10) / 5 mL... | 5 mg/5mL | 50 | $7.75 | — | ● Active | CMS ASP |
| 72611-0740-10 | Metoprolol Tartrate 1 mg/mL INJECTION, SOLUTION | Almaject, | 10 VIAL, SINGLE-DOSE in 1 CARTON (72611-74... | 1 mg/mL | 50 | $7.75 | — | ● 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
$528.23
Claims
666
Beneficiaries
664
Spend / beneficiary
$0.80
Spend / claim
$0.79
Trend by period
Where J0616 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #783 of 824
#778
DEXTROSE IN WATER(J7... J7070
$808.79
#779
METOCLOPRAMIDE HCL J2765
$769.16
#780
BENZTROPINE MESYLATE J0515
$656.40
#781
CIPROFLOXACIN-D5W J0744
$605.35
#782
PROTAMINE SULFATE J2720
$543.58
#783
METOPROLOL TARTRATE J0616
$528.23
#784
RETACRIT(Q5105) Q5105
$522.38
#785
KEPPRA* J1953
$517.51
#786
DAPTOMYCIN(J0873) J0873
$474.41
#787
MEDROL* J7509
$471.06
#788
AFLURIA (90657)* 90657
$440.18
Total claims — #420 of 824
#415
HYPERRAB 90375
686
#416
UPLIZNA J1823
686
#417
YONDELIS J9352
684
#418
ABILIFY MAINTENA J0401
670
#419
VIVITROL J2315
668
#420
METOPROLOL TARTRATE J0616
666
#421
ACAPATCH, PER SQ CM*... Q4325
661
#422
DURAMORPH* J2274
657
#423
KINEVAC* J2805
654
#424
CAREGRAFT, PER SQ CM... Q4322
652
#425
CORTROSYN* J0834
648
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) | $528.23 | 664 | 666 | $0.80 | $0.79 |
| 2025 (Q1-Q4) | $1.2K | 1,067 | 1,074 | $1.14 | $1.13 |
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
$1.2K
Medicare paid
$897.24
Submitted services
10,320
Denial rate
8.8%
Allowed / service
$0.13
Submitted charges
$110.7K
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.
🗺️ Where J0616 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
🗃️ 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
14 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.
❓ J0616 billing FAQ
What is HCPCS code J0616?
J0616 is a HCPCS Level II J-code used to bill Inj metoprolol tartrate 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0616?
One unit of J0616 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J0616 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 J0616?
The Medicare Part B payment limit is $0.155 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.152 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0616?
14 NDCs currently map to J0616 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 J0616 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.