J0891 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J0891 summary

J0891 is a HCPCS Level II J-code used to bill argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use). The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Code J0891 NDC-Crosswalk 2 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 codeJ0891

DescriptorInjection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)

Billing unitNot available in current dataset

Payment limit / unit Not available in current dataset

Mapped NDCs2

Data periodNot available in current dataset

Last updatedSource date not available

💊 About Argatroban DRUG GUIDE

Argatroban is given through a vein to adults for two main purposes.

The first is to prevent or treat blood clots (thrombosis) in people with heparin-induced thrombocytopenia (HIT).

HIT is a reaction to heparin that causes a drop in platelets and a higher risk of clots.The second is as a blood thinner in adults with or at risk for HIT who are having percutaneous coronary intervention (PCI), a procedure to open blocked heart arteries.

Read the full Argatroban drug guide →

Clinical overview from our editorial drug guide for Argatroban. For billing reference, see the sections above.

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit

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Est. ASP / unit

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Est. after 2% sequester

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HCPCS dosage

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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).

Full HCPCS code details (official CMS record)

Long descriptionInjection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)

CoverageD — Special coverage instructions apply

Pricing indicator51 — Drug — priced under the ASP methodology

Type of service9 — Other medical items or services

BETOS-2O1E

ASC payment groupYY

Action codeN — No maintenance this year

Effective date2023-01-01

Date added2023-01-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0891 = 1 unit. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (unit) 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 J0891 CROSSWALKED NDCs

2 NDCs map to J0891. Bill units = how many HCPCS units one package represents.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	NADAC / unit	Status	Source
16729-0430-11	ARGATROBAN 1 mg/mL INJECTION	Accord	1 VIAL, SINGLE-USE in 1 CARTON (16729-430-...	1 mg/mL	1	—	● Active	PDAC
16729-0430-43	ARGATROBAN 1 mg/mL INJECTION	Accord	10 VIAL, SINGLE-USE in 1 CARTON (16729-430...	1 mg/mL	1	—	● 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 J0891 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J0891. 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 J0891
J0883	Argatroban nonesrd use 1mg	1 MG	$0.864	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.

🗺️ Where J0891 is utilized

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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 J0891

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

Argatroban 1

NDC products by labeler

Accord Healthcare Inc. 1

Related NDC directory pages

🧪 All Argatroban NDCsIngredient 🏭 All Accord labeler NDCsLabeler 16729 📚 All Anti-coagulant NDCsDrug class 📚 All Direct Thrombin Inhibitor 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

Loaded

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Not available

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

No reportable utilization

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.

❓ J0891 billing FAQ

What is HCPCS code J0891?

J0891 is a HCPCS Level II J-code used to bill Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use) under Medicare Part B and most medical (not pharmacy) benefits.

Which NDCs bill under J0891?

2 NDCs currently map to J0891 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 J0891 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.

J0891 – Injection, argatroban (accord), not therapeutically equivalent to j0883, · NDC Crosswalk & Billing Units