J0725
J0725 – Injection, chorionic gonadotropin, per 1,000 usp units · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 6 NDCs crosswalked per 1000 UNITS $15.069/unit ASP+6%
📋 J0725 summary
J0725 is a HCPCS Level II J-code used to bill chorionic gonadotropin, per 1,000 usp units, billed per 1000 UNITS. 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 J0725: Chorionic Gonadotropin*, Pregnyl, Novarel
Code J0725
Billing unit 1000 UNITS Payment limit $15.069/unit NDC-Crosswalk 6
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 codeJ0725
DescriptorInjection, chorionic gonadotropin, per 1,000 usp units
Billing unit1000 UNITS
Payment limit / unit$15.069
Est. ASP / unit$14.216 est.
Mapped NDCs6
Data periodQ3 2026
Last updated2026-08-20
🧾 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
$15.069
Est. ASP / unit
$14.216 est.
Est. after 2% sequester
$14.768
HCPCS dosage
1000 UNITS
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, chorionic gonadotropin, per 1,000 usp units
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeP — Payment change
Effective date2024-01-01
Date added1986-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0725 = 1,000 units. 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 J0725 LEAST EXPENSIVE FIRST
6 NDCs map to J0725. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($15.069/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 78206-0150-01 | Pregnyl CHORIOGONADOTROPIN ALFA KIT | Organon | 1 KIT in 1 CARTON (78206-150-01) * 10 mL... | — | 10 | $150.69 | $171.534 | ● Active | CMS + PDAC |
| 55566-1502-01 | Novarel gonadotrophin, chorionic KIT | Ferring | 1 KIT in 1 CARTON (55566-1502-1) * 1 INJ... | — | 5 | $75.35 | $171.810 | ● Active | CMS + PDAC |
| 63323-0030-11 | Chorionic Gonadotropin KIT | Fresenius | 1 KIT in 1 CARTON (63323-030-11) * 10 mL... | — | 10 | $150.69 | $251.584 | ● Active | CMS ASP |
| 50090-7089-00 | PREGNYL CHORIOGONADOTROPIN ALFA KIT | A-S | 1 KIT in 1 KIT (50090-7089-0) * 10 mL in... | — | 10 | $150.69 | — | ● Active | CMS ASP |
| 00052-0315-10 | PREGNYL (W/DILUENT) 10000 U | Unknown | — | — | 10 | $150.69 | — | — | PDAC |
| 55566-1501-01 | NOVAREL (M.D.V.) 10000 U | Unknown | — | — | 10 | $150.69 | — | — | 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
$18.5K
Claims
191
Beneficiaries
29
Spend / beneficiary
$638.82
Spend / claim
$96.99
Trend by period
Where J0725 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #658 of 824
#653
MOXIFLOXACIN J2280
$20.7K
#654
NEBUPENT(J2545)* J2545
$20.4K
#655
DIPRIVAN* J2704
$20.2K
#656
ARTACENT VERICLEN, P... Q4339
$19.8K
#657
CLEVIPREX J0759
$19.2K
#658
CHORIONIC GONADOTROP... J0725
$18.5K
#659
CEFAZOLIN SODIUM-DEX... J0690
$18K
#660
TEPADINA(J9342)* J9342
$17.9K
#661
MYCOPHENOLATE MOFETI... J7528
$17.8K
#662
DACARBAZINE J9130
$17.7K
#663
CLONIDINE HCL* J0735
$17.2K
Total claims — #553 of 824
#548
INTEGRA BMWD** Q4104
198
#549
AMNIO-MAXX OR LITE P... Q4239
197
#550
GRAFIX PLUS, PER SQ... Q4304
197
#551
AMNIO TRI-CORE, PER... Q4295
194
#552
BENEFIX J7195
193
#553
CHORIONIC GONADOTROP... J0725
191
#554
VISUDYNE J3396
190
#555
TRI MEMBRANE WRAP, P... Q4344
188
#556
POLOCAINE-MPF* J0670
185
#557
ADRENALIN(J0169) J0169
184
#558
INVEGA HAFYERA* J2427
184
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) | $18.5K | 29 | 191 | $638.82 | $96.99 |
| 2025 (Q1-Q4) | $301.3K | 239 | 5,949 | $1,260.84 | $50.65 |
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
$306K
Medicare paid
$235.7K
Submitted services
17,334
Denial rate
4.3%
Allowed / service
$18.44
Submitted charges
$1.66M
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 J0725 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 7,151 services across 2 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 J0725
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
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)
6 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
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.
❓ J0725 billing FAQ
What is HCPCS code J0725?
J0725 is a HCPCS Level II J-code used to bill Injection, chorionic gonadotropin, per 1,000 usp units under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0725?
One unit of J0725 represents 1000 UNITS. Report the number of units equal to the dose administered divided by 1000 UNITS.
How many units of J0725 should I bill?
Divide the dose administered by the code's unit size (1000 UNITS) 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 J0725?
The Medicare Part B payment limit is $15.069 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $14.768 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0725?
6 NDCs currently map to J0725 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 J0725 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.