J0694 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0694 summary

J0694 is a HCPCS Level II J-code used to bill cefoxitin sodium, 1 gm, billed per 1 GM. 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 J0694: Cefoxitin, Cefoxitin And Dextrose

Code J0694 Billing unit 1 GM Payment limit $4.285/unit NDC-Crosswalk 20 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 codeJ0694

DescriptorInjection, cefoxitin sodium, 1 gm

Billing unit1 GM

Payment limit / unit$4.285

Est. ASP / unit$4.042 est.

Mapped NDCs20

Data periodQ3 2026

Last updated2026-08-20

💊 About Cefoxitin Injection DRUG GUIDE

Cefoxitin for Injection and Dextrose Injection is used to treat bacterial infections in many parts of the body, including the lungs (pneumonia), urinary tract, abdomen, female reproductive system, bloodstream (septicemia), bones and joints, and skin.

It works only against bacteria — not viruses.Cefoxitin for Injection and Dextrose Injection is also used to prevent infection in people having certain surgeries, including gastrointestinal surgery, vaginal hysterectomy, abdominal hysterectomy, or cesarean section.

It does not have activity against Chlamydia trachomatis, so additional medication may be needed when that germ is suspected.

Read the full Cefoxitin Injection drug guide →

Clinical overview from our editorial drug guide for Cefoxitin 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

$4.285

Est. ASP / unit

$4.042 est.

Est. after 2% sequester

$4.199

HCPCS dosage

1 GM

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, cefoxitin sodium, 1 gm

CoverageD — Special coverage instructions apply

Pricing indicator51 — Drug — priced under the ASP methodology

Type of service1 — Medical care

BETOS-2O1E

ASC payment group—

Action codeN — No maintenance this year

Effective date1997-01-01

Date added1992-01-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0694 = 1 gm. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (gm) 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 J0694 WITH EST. MEDICARE PAY

20 NDCs map to J0694. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($4.285/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00143-9876-10	Cefoxitin 10 g/1 INJECTION, POWDER, FOR SOLUTION	Hikma	10 BOTTLE in 1 CARTON (0143-9876-10) / 1...	10 g/1	100	$428.50	—	● Active	CMS ASP
00143-9877-25	Cefoxitin 2 g/1 INJECTION, POWDER, FOR SOLUTION	Hikma	25 VIAL in 1 CARTON (0143-9877-25) / 1 IN...	2 g/1	50	$214.25	—	● Active	CMS ASP
00143-9878-25	Cefoxitin 1 g/1 INJECTION, POWDER, FOR SOLUTION	Hikma	25 VIAL in 1 CARTON (0143-9878-25) / 1 IN...	1 g/1	25	$107.13	—	● Active	CMS ASP
00264-3123-11	Cefoxitin and Dextrose CEFOXITIN SODIUM 1 g/50mL INJECTION, SOLUTION	B.	24 CONTAINER in 1 CASE (0264-3123-11) / 5...	1 g/50mL	24	$102.84	—	● Active	CMS + PDAC
00264-3125-11	Cefoxitin and Dextrose CEFOXITIN SODIUM 2 g/50mL INJECTION, SOLUTION	B.	24 CONTAINER in 1 CASE (0264-3125-11) / 5...	2 g/50mL	48	$205.68	—	● Active	CMS + PDAC
25021-0109-10	Cefoxitin 1 g/1 INJECTION, POWDER, FOR SOLUTION	Sagent	10 VIAL in 1 CARTON (25021-109-10) / 1 IN...	1 g/1	10	$42.85	—	● Active	CMS ASP
25021-0110-20	Cefoxitin 2 g/1 INJECTION, POWDER, FOR SOLUTION	Sagent	10 VIAL in 1 CARTON (25021-110-20) / 1 IN...	2 g/1	20	$85.70	—	● Active	CMS ASP
25021-0111-99	Cefoxitin 10 g/1 INJECTION, POWDER, FOR SOLUTION	Sagent	10 BOTTLE in 1 CARTON (25021-111-99) / 1...	10 g/1	100	$428.50	—	● Active	CMS ASP
44567-0245-25	Cefoxitin 1 g/1 INJECTION, POWDER, FOR SOLUTION	WG	25 VIAL in 1 CARTON (44567-245-25) / 1 IN...	1 g/1	25	$107.13	—	● Active	CMS + PDAC
44567-0246-25	Cefoxitin 2 g/1 INJECTION, POWDER, FOR SOLUTION	WG	25 VIAL in 1 CARTON (44567-246-25) / 1 IN...	2 g/1	50	$214.25	—	● Active	CMS + PDAC
44567-0247-10	Cefoxitin 10 g/1 INJECTION, POWDER, FOR SOLUTION	WG	10 VIAL, PHARMACY BULK PACKAGE in 1 CARTON...	10 g/1	100	$428.50	—	● Active	CMS + PDAC
63323-0341-25	Cefoxitin 1 g/1 POWDER, FOR SOLUTION	Fresenius	25 VIAL in 1 CARTON (63323-341-25) / 1 PO...	1 g/1	25	$107.13	—	● Active	CMS ASP
63323-0341-29	Cefoxitin 1 g/1 POWDER, FOR SOLUTION	Fresenius	25 VIAL in 1 CARTON (63323-341-29) / 1 PO...	1 g/1	25	$107.13	—	● Active	CMS ASP
63323-0342-25	Cefoxitin 2 g/1 POWDER, FOR SOLUTION	Fresenius	25 VIAL in 1 CARTON (63323-342-25) / 1 PO...	2 g/1	50	$214.25	—	● Active	CMS ASP
63323-0342-29	Cefoxitin 2 g/1 POWDER, FOR SOLUTION	Fresenius	25 VIAL in 1 CARTON (63323-342-29) / 1 PO...	2 g/1	50	$214.25	—	● Active	CMS ASP
44567-0246-85	Cefoxitin 2 g/1 INJECTION, POWDER, FOR SOLUTION	WG	25 VIAL in 1 CARTON (44567-246-85) / 1 IN...	2 g/1	2	$8.57	—	● Active	PDAC
60505-0760-01	CEFOXITIN SODIUM 2 GM	Unknown	—	—	2	$8.57	—	—	PDAC
60505-0761-01	CEFOXITIN SODIUM (BULK PACKAGE) 10 GM	Unknown	—	—	10	$42.85	—	—	PDAC
60505-0761-04	CEFOXITIN (BULK PACKAGE) 10 GM	Unknown	—	—	10	$42.85	—	—	PDAC
60505-0760-05	CEFOXITIN 2 GM	Unknown	—	—	2	$8.57	—	—	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

$1.2K

Claims

170

Beneficiaries

71

Spend / beneficiary

$16.85

Spend / claim

$7.04

Trend by period

Where J0694 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #763 of 824

#758 HYDRALAZINE HCL J0360 $1.3K #759 DOXY 100* J1271 $1.3K #760 CYTARABINE J9100 $1.2K #761 POSACONAZOLE J1837 $1.2K #762 BUMETANIDE J1939 $1.2K #763 CEFOXITIN SODIUM* J0694 $1.2K #764 GASTROGRAFIN* Q9963 $1.1K #765 VANCOMYCIN HCL(J3374... J3374 $1.1K #766 METHOCARBAMOL* J2800 $1.1K #767 TYZAVAN* J3375 $1.1K #768 PENICILLIN G POTASSI... J2540 $1.1K

Total claims — #570 of 824

#565 BESPONSA J9229 175 #566 PANHEMATIN J1640 174 #567 STELARA(J3358)* J3358 173 #568 IMIPENEM-CILASTATIN... J0743 172 #569 QALSODY J1304 172 #570 CEFOXITIN SODIUM* J0694 170 #571 IBANDRONATE SODIUM J1740 170 #572 AMNIPLY, PER SQ CM** Q4249 169 #573 YEZTUGO(J0752) J0752 165 #574 NITROGLYCERIN IN D5W... J2305 164 #575 PRIALT J2278 163

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$1.2K	71	170	$16.85	$7.04
2025 (Q1-Q4)	$13.7K	359	823	$38.13	$16.63

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

$13.3K

Medicare paid

$10.6K

Submitted services

7,241

Denial rate

61.7%

Allowed / service

$4.81

Submitted charges

$183.4K

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 J0694 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 488 services across 4 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 J0694

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

Cefoxitin 7

CEFOXITIN SODIUM 2

NDC products by labeler

WG Critical Care, LLC 7

B. Braun Medical Inc. 2

🔗 Related NDC directory pages

🧪 All Cefoxitin NDCsIngredient 🧪 All Cefoxitin Sodium NDCsIngredient 🏭 All WG labeler NDCsLabeler 44567 🏭 All B. labeler NDCsLabeler 00264 📚 All Cephalosporin Antibacterial 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

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)

20 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.

❓ J0694 billing FAQ

What is HCPCS code J0694?

J0694 is a HCPCS Level II J-code used to bill Injection, cefoxitin sodium, 1 gm under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J0694?

One unit of J0694 represents 1 GM. Report the number of units equal to the dose administered divided by 1 GM.

How many units of J0694 should I bill?

Divide the dose administered by the code's unit size (1 GM) 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 J0694?

The Medicare Part B payment limit is $4.285 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $4.199 per unit. Payment limits are revised quarterly.

Which NDCs bill under J0694?

20 NDCs currently map to J0694 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 J0694 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.

J0694 – Injection, cefoxitin sodium, 1 gm · NDC Crosswalk & Billing Units