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J0712

J0712 – Injection, ceftaroline fosamil, 10 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 4 NDCs crosswalked per 10 MG $4.390/unit ASP+6%

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

📋 J0712 summary

J0712 is a HCPCS Level II J-code used to bill ceftaroline fosamil, 10 mg, billed per 10 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 J0712: Ceftaroline Fosamil*, Teflaro, Ceftaroline Fosamil

Code J0712 Billing unit 10 MG Payment limit $4.390/unit NDC-Crosswalk 4 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 codeJ0712
DescriptorInjection, ceftaroline fosamil, 10 mg
Billing unit10 MG
Payment limit / unit$4.390
Est. ASP / unit$4.142 est.
Mapped NDCs4
Data periodQ3 2026
Last updated2026-08-20

💊 About Ceftaroline Injection DRUG GUIDE

Teflaro (ceftaroline fosamil) injection is used to treat two types of serious bacterial infections: acute bacterial skin and skin structure infections (ABSSSI) — serious skin and wound infections — and community-acquired bacterial pneumonia (CABP), a lung infection caught outside of a hospital setting.It works against a range of bacteria, including Staphylococcus aureus (including MRSA, the antibiotic-resistant strain), Streptococcus pneumoniae, and several other Gram-positive and Gram-negative bacteria.

It should only be used when a bacterial infection is confirmed or strongly suspected — not for viral illnesses like colds or flu.

Read the full Ceftaroline Injection drug guide →
Clinical overview from our editorial drug guide for Ceftaroline 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
$4.390
Est. ASP / unit
$4.142 est.
Est. after 2% sequester
$4.302
HCPCS dosage
10 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.
Full HCPCS code details (official CMS record)
Long descriptionInjection, ceftaroline fosamil, 10 mg
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 date2016-01-01
Date added2012-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0712 = 10 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 J0712 WITH EST. MEDICARE PAY

4 NDCs map to J0712. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($4.390/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
00456-0400-10 Teflaro ceftaroline fosamil 400 mg/20mL POWDER, FOR SOLUTION Allergan, 10 VIAL, SINGLE-DOSE in 1 CARTON (0456-040... 400 mg/20mL 400 $1,756.00 — ● Active CMS ASP
00456-0600-10 Teflaro ceftaroline fosamil 600 mg/20mL POWDER, FOR SOLUTION Allergan, 10 VIAL, SINGLE-DOSE in 1 CARTON (0456-060... 600 mg/20mL 600 $2,634.00 — ● Active CMS ASP
60505-6124-01 Ceftaroline Fosamil 400 mg/20mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION Apotex 10 VIAL, SINGLE-DOSE in 1 CARTON (60505-61... 400 mg/20mL 400 $1,756.00 — ● Active CMS ASP
60505-6125-01 Ceftaroline Fosamil 600 mg/20mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION Apotex 10 VIAL, SINGLE-DOSE in 1 CARTON (60505-61... 600 mg/20mL 600 $2,634.00 — ● 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
$80K
Claims
122
Beneficiaries
22
Spend / beneficiary
$3,637.74
Spend / claim
$655.99
Trend by period
Where J0712 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #578 of 824
#573 PALISADE DM MATRIX P... Q4350 $94.1K #574 CISPLATIN J9060 $89.5K #575 JOBEVNE Q5160 $87.9K #576 CYSVIEW A9589 $85.5K #577 ABILIFY ASIMTUFII J0402 $83.9K #578 CEFTAROLINE FOSAMIL* J0712 $80K #579 DEFEROXAMINE MESYLAT... J0895 $78.6K #580 DAPTOMYCIN(J0872) J0872 $78.1K #581 GRAFIX CORE, GRAFIXP... Q4132 $76.1K #582 PREVNAR 13 90670 $76K #583 DIPHENHYDRAMINE HCL J1200 $75.7K
Total claims — #608 of 824
#603 LEVOTHYROXINE SODIUM... J0651 128 #604 TEVIMBRA J9329 128 #605 ONDANSETRON HCL(Q016... Q0162 127 #606 AMNIO QUAD-CORE, PER... Q4294 126 #607 EPYSQLI Q5151 124 #608 CEFTAROLINE FOSAMIL* J0712 122 #609 ELOCTATE J7205 122 #610 AZITHROMYCIN* J0456 121 #611 MATRION 1 SQ CM** Q4201 121 #612 PAMIDRONATE DISODIUM J2430 118 #613 REEVA, PER SQ CM** Q4314 118

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $80K 22 122 $3,637.74 $655.99
2025 (Q1-Q4) $223.4K 89 443 $2,510.63 $504.39
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
$139.1K
Medicare paid
$109K
Submitted services
227,820
Denial rate
85.3%
Allowed / service
$4.16
Submitted charges
$3.93M
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
4 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.

❓ J0712 billing FAQ

What is HCPCS code J0712?
J0712 is a HCPCS Level II J-code used to bill Injection, ceftaroline fosamil, 10 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0712?
One unit of J0712 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of J0712 should I bill?
Divide the dose administered by the code's unit size (10 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 J0712?
The Medicare Part B payment limit is $4.390 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $4.302 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0712?
4 NDCs currently map to J0712 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 J0712 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.