J0743
J0743 – Injection, cilastatin sodium; imipenem, per 250 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 6 NDCs crosswalked per 250 MG $6.517/unit ASP+6%
📋 J0743 summary
J0743 is a HCPCS Level II J-code used to bill cilastatin sodium; imipenem, per 250 mg, billed per 250 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 J0743: Imipenem-Cilastatin Sodium*, Primaxin Iv, Imipenem And Cilastatin
Code J0743
Billing unit 250 MG Payment limit $6.517/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 codeJ0743
DescriptorInjection, cilastatin sodium; imipenem, per 250 mg
Billing unit250 MG
Payment limit / unit$6.517
Est. ASP / unit$6.148 est.
Mapped NDCs6
Data periodQ3 2026
Last updated2026-08-20
💊 About Imipenem and Cilastatin Injection DRUG GUIDE
Imipenem and cilastatin for injection is used intravenously to treat a wide range of serious bacterial infections in adults and children.
These include lower respiratory tract infections, urinary tract infections (both complicated and uncomplicated), intra-abdominal infections, gynecologic infections, bacterial septicemia (a serious bloodstream infection), bone and joint infections, skin and skin structure infections, and endocarditis (infection of the heart's inner lining).It is not approved to treat meningitis (brain/spinal cord infection), and it is not recommended for CNS (central nervous system) infections in children due to the risk of seizures.
It should only be used for infections that are proven or strongly suspected to be caused by susceptible bacteria.
Clinical overview from our editorial drug guide for Imipenem and Cilastatin 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
$6.517
Est. ASP / unit
$6.148 est.
Est. after 2% sequester
$6.387
HCPCS dosage
250 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, cilastatin sodium; imipenem, per 250 mg
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 added1993-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0743 = 250 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 J0743 WITH EST. MEDICARE PAY
6 NDCs map to J0743. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($6.517/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00006-3516-59 | PRIMAXIN IV imipenem and cilastatin sodium 500 mg/100mL; 500 mg/100mL INJECTION, POWDER, FOR SOLUTION | Merck | 25 VIAL, SINGLE-DOSE in 1 TRAY (0006-3516-... | 500 mg/100mL; 500 mg/100mL | 50 | $325.85 | — | ● Active | CMS + PDAC |
| 44567-0705-10 | Imipenem and Cilastatin 500 mg/1; 500 mg/1 INJECTION, POWDER, FOR SOLUTION | WG | 10 VIAL in 1 CARTON (44567-705-10) / 1 IN... | 500 mg/1; 500 mg/1 | 20 | $130.34 | — | ● Active | CMS + PDAC |
| 63323-0322-25 | Imipenem and Cilastatin 500 mg/20mL; 500 mg/20mL INJECTION, POWDER, FOR SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-32... | 500 mg/20mL; 500 mg/20mL | 50 | $325.85 | — | ● Active | CMS ASP |
| 63323-0322-93 | Imipenem and Cilastatin 500 mg/20mL; 500 mg/20mL INJECTION, POWDER, FOR SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-32... | 500 mg/20mL; 500 mg/20mL | 50 | $325.85 | — | ● Active | CMS ASP |
| 63323-0322-94 | Imipenem and Cilastatin 500 mg/20mL; 500 mg/20mL INJECTION, POWDER, FOR SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-32... | 500 mg/20mL; 500 mg/20mL | 50 | $325.85 | — | ● Active | CMS ASP |
| 63323-0349-25 | Imipenem and Cilastatin 250 mg/20mL; 250 mg/20mL INJECTION, POWDER, FOR SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-34... | 250 mg/20mL; 250 mg/20mL | 25 | $162.93 | — | ● 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
$13.1K
Claims
172
Beneficiaries
20
Spend / beneficiary
$656.89
Spend / claim
$76.38
Trend by period
Where J0743 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #675 of 824
#670
PIPERACILLIN-TAZOBAC... J2543
$14.7K
#671
MULTIHANCE MULTIPACK A9578
$13.7K
#672
FLUDARABINE PHOSPHAT... J9185
$13.6K
#673
MICAFUNGIN(J2248)* J2248
$13.4K
#674
CORTROSYN* J0834
$13.2K
#675
IMIPENEM-CILASTATIN... J0743
$13.1K
#676
FOSCARNET SODIUM J1455
$12.6K
#677
SURGRAFT XT PER SQ C... Q4269
$12.3K
#678
TOBRAMYCIN SULFATE J3260
$12.3K
#679
PHENERGAN* J2550
$12.2K
#680
IFEX* J9208
$11.9K
Total claims — #568 of 824
#563
PHENTOLAMINE MESYLAT... J2760
175
#564
CROMOLYN SODIUM J7631
175
#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
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) | $13.1K | 20 | 172 | $656.89 | $76.38 |
| 2025 (Q1-Q4) | $87.6K | 62 | 1,104 | $1,413.48 | $79.38 |
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
$88.8K
Medicare paid
$69.8K
Submitted services
41,295
Denial rate
73.5%
Allowed / service
$8.11
Submitted charges
$2.38M
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 J0743 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 3,736 services across 1 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 J0743
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)
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.
❓ J0743 billing FAQ
What is HCPCS code J0743?
J0743 is a HCPCS Level II J-code used to bill Injection, cilastatin sodium; imipenem, per 250 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0743?
One unit of J0743 represents 250 MG. Report the number of units equal to the dose administered divided by 250 MG.
How many units of J0743 should I bill?
Divide the dose administered by the code's unit size (250 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 J0743?
The Medicare Part B payment limit is $6.517 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $6.387 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0743?
6 NDCs currently map to J0743 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 J0743 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.