J0681
J0681 – Inj ceftobipole medocarl 3mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 1 NDC crosswalked per 3 MG $1.098/unit ASP+6%
📋 J0681 summary
J0681 is a HCPCS Level II J-code used to bill ceftobipole medocarl 3mg, billed per 3 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 J0681: Zevtera
Code J0681
Billing unit 3 MG Payment limit $1.098/unit NDC-Crosswalk 1
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 codeJ0681
DescriptorInj ceftobipole medocarl 3mg
Billing unit3 MG
Payment limit / unit$1.098
Est. ASP / unit$1.036 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-09-20
🧾 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
$1.098
Est. ASP / unit
$1.036 est.
Est. after 2% sequester
$1.076
HCPCS dosage
3 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 J0681 = 3 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 J0681 WITH EST. MEDICARE PAY
1 NDC map to J0681. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.098/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 68547-0578-10 | ZEVTERA ceftobiprole medocaril sodium 667 mg/1 INJECTION, POWDER, FOR SOLUTION | La | 10 VIAL, GLASS in 1 BOX (68547-578-10) /... | 667 mg/1 | 2,224 | $2,441.95 | — | ● 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 · 2025 (Q1-Q4)
Total Part B spend
$24.2K
Claims
51
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$473.61
Where J0681 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #763 of 918
#758
HYLENEX J3473
$28.1K
#759
PREMARIN J1410
$27.2K
#760
CALCIUM GLUCONATE-NA... J0612
$26K
#761
DELESTROGEN* J1380
$25.3K
#762
OCTREOTIDE ACETATE* J2354
$25.1K
#763
ZEVTERA J0681
$24.2K
#764
HALDOL DECANOATE 100... J1631
$23.7K
#765
DEMEROL* J2175
$23.7K
#766
MATRISTEM MICROMATRI... Q4118
$23.6K
#767
LEVOTHYROXINE SODIUM... J0650
$22.9K
#768
YCANTH J7354
$21.4K
Total claims — #844 of 918
#839
TEPADINA(J9340)* J9340
56
#840
TEPADINA(J9342)* J9342
54
#841
DEXAMETHASONE INTENS... J8540
53
#842
CANCIDAS* J0637
52
#843
IXINITY J7213
52
#844
ZEVTERA J0681
51
#845
CLINDAMYCIN-0.9% NAC... J0737
51
#846
CROFAB J0840
51
#847
ARTACENT VERICLEN, P... Q4339
51
#848
FLUPHENAZINE HCL J2679
50
#849
ARRANON* J9261
49
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 (1)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2025 (Q1-Q4) | $24.2K | — | 51 | — | $473.61 |
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
$24.8K
Medicare paid
$19.4K
Submitted services
24,096
Denial rate
5.7%
Allowed / service
$1.09
Submitted charges
$237.7K
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 J0681
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
Not available in current dataset
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
1 NDC 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 2025
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.
❓ J0681 billing FAQ
What is HCPCS code J0681?
J0681 is a HCPCS Level II J-code used to bill Inj ceftobipole medocarl 3mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0681?
One unit of J0681 represents 3 MG. Report the number of units equal to the dose administered divided by 3 MG.
How many units of J0681 should I bill?
Divide the dose administered by the code's unit size (3 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 J0681?
The Medicare Part B payment limit is $1.098 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.076 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0681?
1 NDC currently map to J0681 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 J0681 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.