J0870
J0870 – Injection, imetelstat, 1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 1 MG $59.531/unit ASP+6%
📋 J0870 summary
J0870 is a HCPCS Level II J-code used to bill imetelstat, 1 mg, billed per 1 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 J0870: Rytelo
Code J0870
Billing unit 1 MG Payment limit $59.531/unit NDC-Crosswalk 2
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 codeJ0870
DescriptorInjection, imetelstat, 1 mg
Billing unit1 MG
Payment limit / unit$59.531
Est. ASP / unit$56.161 est.
Mapped NDCs2
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
$59.531
Est. ASP / unit
$56.161 est.
Est. after 2% sequester
$58.340
HCPCS dosage
1 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 J0870 = 1 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 J0870 WITH EST. MEDICARE PAY
2 NDCs map to J0870. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($59.531/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 82959-0111-01 | RYTELO imetelstat sodium 188 mg/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Geron | 1 VIAL, SINGLE-DOSE in 1 CARTON (82959-111... | 188 mg/1 | 188 | $11,191.83 | — | ● Active | CMS + PDAC |
| 82959-0112-01 | RYTELO imetelstat sodium 47 mg/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Geron | 1 VIAL, SINGLE-DOSE in 1 CARTON (82959-112... | 47 mg/1 | 47 | $2,797.96 | — | ● 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 · 2026 (Q1)
Period
Total Part B spend
$26.72M
Claims
1,030
Beneficiaries
450
Spend / beneficiary
$59,375.68
Spend / claim
$25,940.83
Trend by period
Where J0870 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #109 of 824
#104
DATROWAY J9011
$29.34M
#105
ALTUVIIIO J7214
$29.24M
#106
BLINCYTO J9039
$28.12M
#107
SKYRIZI J2327
$27.14M
#108
AVASTIN J9035
$27.11M
#109
RYTELO J0870
$26.72M
#110
INJECTAFER J1439
$25.65M
#111
JEVTANA J9043
$25.22M
#112
MNEXSPIKE (12Y UP) 91323
$25.16M
#113
KIMMTRAK J9274
$24.06M
#114
PANZYGA J1576
$23.9M
Total claims — #371 of 824
#366
CEFTAZIDIME* J0713
1,095
#367
RYSTIGGO J9333
1,074
#368
TNKASE J3101
1,069
#369
PEMGARDA (EUA) Q0224
1,056
#370
VIVIMUSTA J9056
1,048
#371
RYTELO J0870
1,030
#372
CUTAQUIG J1551
1,016
#373
KIMMTRAK J9274
997
#374
PROCHLORPERAZINE EDI... J0780
996
#375
TEPEZZA J3241
985
#376
POTELIGEO J9204
976
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) | $26.72M | 450 | 1,030 | $59,375.68 | $25,940.83 |
| 2025 (Q1-Q4) | $95.45M | 841 | 3,756 | $113,499.10 | $25,413.40 |
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
$42.58M
Medicare paid
$32.98M
Submitted services
822,428
Denial rate
7.3%
Allowed / service
$55.84
Submitted charges
$120.87M
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 J0870 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
📊 What bills under J0870
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 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
2 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.
❓ J0870 billing FAQ
What is HCPCS code J0870?
J0870 is a HCPCS Level II J-code used to bill Injection, imetelstat, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0870?
One unit of J0870 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J0870 should I bill?
Divide the dose administered by the code's unit size (1 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 J0870?
The Medicare Part B payment limit is $59.531 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $58.340 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0870?
2 NDCs currently map to J0870 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 J0870 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.