J0872 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0872 summary

J0872 is a HCPCS Level II J-code used to bill Daptomycin (xellia) unrefrig, 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 J0872: Daptomycin(J0872)

Code J0872 Billing unit 1 MG Payment limit $0.042/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 codeJ0872

DescriptorDaptomycin (xellia) unrefrig

Billing unit1 MG

Payment limit / unit$0.042

Est. ASP / unit$0.040 est.

Mapped NDCs4

Data periodQ3 2026

Last updated2026-08-20

💊 About Daptomycin DRUG GUIDE

Daptomycin injection is used to treat complicated skin and skin structure infections (cSSSI) caused by certain Gram-positive bacteria, including MRSA (methicillin-resistant Staphylococcus aureus).

It is also used to treat Staphylococcus aureus bloodstream infections (bacteremia), including right-sided infective endocarditis (a serious infection of the heart's right-side valves), in adults.

Several products — including Daptomycin in Sodium Chloride Injection, Dapzura RT, and others — extend these uses to pediatric patients aged 1 to 17 years for both cSSSI and S.

aureus bacteremia.Daptomycin is not used to treat pneumonia or left-sided infective endocarditis, and it is not recommended for infants younger than 1 year of age.

Read the full Daptomycin drug guide →

Clinical overview from our editorial drug guide for Daptomycin. 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

$0.042

Est. ASP / unit

$0.040 est.

Est. after 2% sequester

$0.041

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 J0872 = 1 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) 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 J0872 LEAST EXPENSIVE FIRST

4 NDCs map to J0872. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.042/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
70594-0066-01	Daptomycin 350 mg/7mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	Xellia	1 VIAL, SINGLE-USE in 1 CARTON (70594-066-...	350 mg/7mL	350	$14.70	$13.418	● Active	CMS + PDAC
70594-0060-01	Daptomycin 500 mg/10mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	Xellia	1 VIAL, SINGLE-USE in 1 CARTON (70594-060-...	500 mg/10mL	500	$21.00	$20.769	● Active	CMS + PDAC
72572-0158-01	Daptomycin 500 mg/10mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	Civica,	1 VIAL, SINGLE-USE in 1 CARTON (72572-158-...	500 mg/10mL	500	$21.00	—	● Active	PDAC
00143-9445-01	Daptomycin 500 mg/10mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	Hikma	1 VIAL, SINGLE-USE in 1 CARTON (0143-9445-...	500 mg/10mL	500	$21.00	—	● Active	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.

⚠️ Don't confuse J0872 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J0872. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J0872
J0878	Daptomycin injection	1 MG	$0.029	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J0873	Inj, daptomycin (xellia)	1 MG	$0.045	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J0874	Inj, daptomycin (baxter)	1 MG	$0.060	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J0877	Inj, daptomycin (hospira)	1 MG	$0.057	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$78.1K

Claims

1,843

Beneficiaries

154

Spend / beneficiary

$507.34

Spend / claim

$42.39

Trend by period

Where J0872 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #580 of 824

#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 #584 ERZOFRI J2428 $74.6K #585 TEMSIROLIMUS* J9330 $73.9K

Total claims — #328 of 824

#323 ALBUTEROL SULFATE(J7... J7611 1,926 #324 VINCASAR PFS* J9370 1,920 #325 MITOMYCIN J9280 1,891 #326 EMTRICITABINE-TENOFO... J0750 1,859 #327 ZOLADEX J9202 1,858 #328 DAPTOMYCIN(J0872) J0872 1,843 #329 JEVTANA J9043 1,832 #330 QUZYTTIR J1201 1,770 #331 TOFIDENCE Q5133 1,736 #332 BIVIGAM J1556 1,700 #333 ERIBULIN MESYLATE* J9179 1,689

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$78.1K	154	1,843	$507.34	$42.39
2025 (Q1-Q4)	$157.3K	429	4,791	$366.66	$32.83

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

$128K

Medicare paid

$99.9K

Submitted services

8,476,443

Denial rate

68.6%

Allowed / service

$0.05

Submitted charges

$22.16M

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 J0872 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 2,637,395 services across 5 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 J0872

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

daptomycin 4

NDC products by labeler

Xellia Pharmaceuticals USA LLC 2

Hikma Pharmaceuticals USA Inc. 1

Civica, Inc. 1

🔗 Related NDC directory pages

🧪 All Daptomycin NDCsIngredient 🏭 All Xellia labeler NDCsLabeler 70594 🏭 All Hikma labeler NDCsLabeler 00143 🏭 All Civica, labeler NDCsLabeler 72572 📚 All Lipopeptide 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

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)

4 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.

❓ J0872 billing FAQ

What is HCPCS code J0872?

J0872 is a HCPCS Level II J-code used to bill Daptomycin (xellia) unrefrig under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J0872?

One unit of J0872 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.

How many units of J0872 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 J0872?

The Medicare Part B payment limit is $0.042 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.041 per unit. Payment limits are revised quarterly.

Which NDCs bill under J0872?

4 NDCs currently map to J0872 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 J0872 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.

J0872 – Daptomycin (xellia) unrefrig · NDC Crosswalk & Billing Units