J1160
J1160 – Injection, digoxin, up to 0.5 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 12 NDCs crosswalked per 0.5 MG $3.911/unit ASP+6%
📋 J1160 summary
J1160 is a HCPCS Level II J-code used to bill digoxin, up to 0.5 mg, billed per 0.5 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 J1160: Digoxin, Lanoxin
Code J1160
Billing unit 0.5 MG Payment limit $3.911/unit NDC-Crosswalk 12
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 codeJ1160
DescriptorInjection, digoxin, up to 0.5 mg
Billing unit0.5 MG
Payment limit / unit$3.911
Est. ASP / unit$3.690 est.
Mapped NDCs12
Data periodQ3 2026
Last updated2026-08-20
💊 About Digoxin DRUG GUIDE
Digoxin tablets, oral solution, and injections (including Lanoxin brand) are all approved to treat mild to moderate heart failure in adults — improving symptoms like exercise tolerance and reducing hospitalizations, though it does not extend life.
It is also approved to control the resting ventricular rate (how fast the lower chambers beat) in adults with chronic atrial fibrillation.
The oral solution specifically notes it should not be used for multifocal atrial tachycardia.In children with heart failure, digoxin is used to strengthen the heart's contractions (increase myocardial contractility).
Digoxin is best used alongside a diuretic (water pill) and an ACE inhibitor when possible.
Clinical overview from our editorial drug guide for Digoxin. 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
$3.911
Est. ASP / unit
$3.690 est.
Est. after 2% sequester
$3.833
HCPCS dosage
0.5 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, digoxin, up to 0.5 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 added1982-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J1160 = 0.5 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 J1160 WITH EST. MEDICARE PAY
12 NDCs map to J1160. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($3.911/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00404-9850-02 | Digoxin .25 mg/mL INJECTION | Henry | 1 AMPULE in 1 BAG (0404-9850-02) / 2 mL i... | .25 mg/mL | 1 | $3.91 | — | ● Active | CMS ASP |
| 00641-1410-35 | Digoxin .25 mg/mL INJECTION | Hikma | 25 AMPULE in 1 CARTON (0641-1410-35) / 2... | .25 mg/mL | 25 | $97.78 | — | ● Active | CMS ASP |
| 00641-6184-25 | Digoxin .25 mg/mL INJECTION | Hikma | 25 AMPULE in 1 CARTON (0641-6184-25) / 2... | .25 mg/mL | 25 | $97.78 | — | ● Active | CMS ASP |
| 00781-3059-95 | Digoxin 250 ug/mL INJECTION, SOLUTION | Sandoz | 10 AMPULE in 1 CARTON (0781-3059-95) / 2... | 250 ug/mL | 10 | $39.11 | — | ● Active | CMS + PDAC |
| 51662-1217-01 | DIGOXIN .25 mg/mL INJECTION | HF | 2 mL in 1 AMPULE (51662-1217-1) | .25 mg/mL | 1 | $3.91 | — | ● Active | CMS ASP |
| 51662-1217-03 | DIGOXIN .25 mg/mL INJECTION | HF | 25 POUCH in 1 CASE (51662-1217-3) / 1 mL... | .25 mg/mL | 25 | $97.78 | — | ● Active | CMS ASP |
| 70515-0260-10 | Lanoxin | Covis | — | — | 10 | $39.11 | — | — | CMS + PDAC |
| 70515-0261-10 | LANOXIN digoxin 250 ug/mL INJECTION, SOLUTION | Covis | 10 VIAL in 1 BOX (70515-261-10) / 2 mL in... | 250 ug/mL | 10 | $39.11 | — | ● Active | CMS + PDAC |
| 70515-0262-10 | Lanoxin | Covis | — | — | 2 | $7.82 | — | — | CMS + PDAC |
| 70515-0263-10 | LANOXIN digoxin 100 ug/mL INJECTION, SOLUTION | Covis | 10 VIAL in 1 BOX (70515-263-10) / 1 mL in... | 100 ug/mL | 2 | $7.82 | — | ● Active | CMS + PDAC |
| 00641-1410-31 | DIGOXIN (USP) 0.25 MG/ML | Unknown | — | — | 0.5 | $1.96 | — | — | PDAC |
| 38779-0215-09 | DIGOXIN (U.S.P.) | Unknown | — | — | 2,000 | $7,822.00 | — | — | 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 · 2025 (Q1-Q4)
Total Part B spend
$194.10
Claims
23
Beneficiaries
22
Spend / beneficiary
$8.82
Spend / claim
$8.44
Where J1160 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #908 of 918
#903
DILTIAZEM HCL-0.9% N... J1163
$358.61
#904
CEFEPIME-DEXTROSE J0703
$304.66
#905
DEXAMETHASONE INTENS... J8540
$295.16
#906
BREVIBLOC* J1805
$241.23
#907
CLINDAMYCIN-0.9% NAC... J0737
$227.02
#908
DIGOXIN* J1160
$194.10
#909
INJ, EPINEPHRINE (BE... J0173
$178.00
#910
BUPRENORPHINE HCL J0592
$176.82
#911
NALOXONE HCL(J2312) J2312
$139.40
#912
PHENYTOIN SODIUM J1165
$131.91
#913
CHLOROPROCAINE HCL* J2401
$114.74
Total claims — #887 of 918
#882
MATRION 1 SQ CM** Q4201
26
#883
DAPTOMYCIN(J0877) J0877
25
#884
KEPIVANCE J2425
25
#885
HYMPAVZI PEN J7172
25
#886
ROMIDEPSIN J9318
24
#887
DIGOXIN* J1160
23
#888
NALOXONE HCL(J2312) J2312
23
#889
RIASTAP J7178
22
#890
CHORIPLY, PER SQ CM*... Q4359
22
#891
EPOGEN(Q4081)* Q4081
21
#892
ETHAMOLIN J1430
20
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 (1)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2025 (Q1-Q4) | $194.10 | 22 | 23 | $8.82 | $8.44 |
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
—
Medicare paid
$140.48
Submitted services
—
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.
📊 What bills under J1160
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)
12 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 2025
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.
❓ J1160 billing FAQ
What is HCPCS code J1160?
J1160 is a HCPCS Level II J-code used to bill Injection, digoxin, up to 0.5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1160?
One unit of J1160 represents 0.5 MG. Report the number of units equal to the dose administered divided by 0.5 MG.
How many units of J1160 should I bill?
Divide the dose administered by the code's unit size (0.5 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 J1160?
The Medicare Part B payment limit is $3.911 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $3.833 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1160?
12 NDCs currently map to J1160 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 J1160 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.