J1171
J1171 – Inj, hydromorphone, 0.1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 44 NDCs crosswalked per 0.1 MG $0.136/unit ASP+6%
📋 J1171 summary
J1171 is a HCPCS Level II J-code used to bill hydromorphone, 0.1 mg, billed per 0.1 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 J1171: Dilaudid*, Hydromorphone Hydrochloride, Dilaudid
Code J1171
Billing unit 0.1 MG Payment limit $0.136/unit NDC-Crosswalk 44
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 codeJ1171
DescriptorInj, hydromorphone, 0.1 mg
Billing unit0.1 MG
Payment limit / unit$0.136
Est. ASP / unit$0.128 est.
Mapped NDCs44
Data periodQ3 2026
Last updated2026-08-20
💊 About Hydromorphone Injection DRUG GUIDE
Hydromorphone Hydrochloride Injection is used to manage severe pain when non-opioid or combination pain relievers have not worked or are not expected to work.
It is given only when the pain is serious enough to require an opioid and when other options are inadequate.Hydromorphone Hydrochloride Injection High Potency Formulation (HPF) is a more concentrated version intended only for patients who are already opioid-tolerant — meaning they are already taking significant daily doses of opioids regularly.
It should not be used in patients who have not built up a tolerance to opioids.
Clinical overview from our editorial drug guide for Hydromorphone 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
$0.136
Est. ASP / unit
$0.128 est.
Est. after 2% sequester
$0.133
HCPCS dosage
0.1 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 J1171 = 0.1 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 J1171 LEAST EXPENSIVE FIRST
44 NDCs map to J1171. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.136/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00409-2634-05 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Hospira, | 10 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-0... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS ASP |
| 00409-2634-50 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Hospira, | 1 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-50... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS ASP |
| 00703-0018-01 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Teva | 1 VIAL in 1 CARTON (0703-0018-01) / 50 mL... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS ASP |
| 00703-0113-03 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Teva | 10 VIAL in 1 CARTON (0703-0113-03) / 5 mL... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS ASP |
| 63323-0851-15 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Fresenius | 10 VIAL, SINGLE-DOSE in 1 CARTON (63323-85... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS + PDAC |
| 63323-0851-50 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Fresenius | 50 mL in 1 VIAL, SINGLE-DOSE (63323-851-50... | 10 mg/mL | 5,000 | $680.00 | $2.566 | ● Active | CMS + PDAC |
| 00641-6151-25 | Hydromorphone Hydrochloride 2 mg/mL INJECTION | Hikma | 25 VIAL, SINGLE-DOSE in 1 CARTON (0641-615... | 2 mg/mL | 500 | $68.00 | $2.740 | ● Active | CMS + PDAC |
| 63323-0853-25 | Hydromorphone Hydrochloride 2 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-85... | 2 mg/mL | 500 | $68.00 | $2.740 | ● Active | CMS + PDAC |
| 00409-1312-30 | Hydromorphone Hydrochloride 2 mg/mL INJECTION, SOLUTION | Hospira, | 10 CARTRIDGE in 1 CARTON (0409-1312-30) /... | 2 mg/mL | 200 | $27.20 | $3.245 | ● Active | CMS + PDAC |
| 00409-1283-31 | Hydromorphone Hydrochloride 1 mg/mL INJECTION, SOLUTION | Hospira, | 10 CARTRIDGE in 1 CARTON (0409-1283-31) /... | 1 mg/mL | 100 | $13.60 | — | ● Active | CMS + PDAC |
| 00409-1283-37 | Hydromorphone Hydrochloride 1 mg/mL INJECTION, SOLUTION | Hospira, | 10 SYRINGE in 1 CELLO PACK (0409-1283-37)... | 1 mg/mL | 100 | $13.60 | — | ● Active | CMS + PDAC |
| 00409-1304-31 | Hydromorphone Hydrochloride 4 mg/mL INJECTION, SOLUTION | Hospira, | 10 CARTRIDGE in 1 CARTON (0409-1304-31) /... | 4 mg/mL | 400 | $54.40 | — | ● Active | CMS + PDAC |
| 00409-1312-36 | Hydromorphone Hydrochloride 2 mg/mL INJECTION, SOLUTION | Hospira, | 10 SYRINGE in 1 CELLO PACK (0409-1312-36)... | 2 mg/mL | 200 | $27.20 | — | ● Active | CMS + PDAC |
| 00409-1805-01 | Hydromorphone Hydrochloride .25 mg/.5mL INJECTION, SOLUTION | Hospira, | 10 SYRINGE in 1 CELLO PACK (0409-1805-01)... | .25 mg/.5mL | 25 | $3.40 | — | ● Active | CMS + PDAC |
| 00409-2634-01 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Hospira, | 10 VIAL, SINGLE-DOSE in 1 BOX (0409-2634-0... | 10 mg/mL | 1,000 | $136.00 | — | ● Active | CMS ASP |
| 00409-3365-10 | Hydromorphone Hydrochloride 2 mg/mL INJECTION, SOLUTION | Hospira, | 10 VIAL, SINGLE-DOSE in 1 CARTON (0409-336... | 2 mg/mL | 200 | $27.20 | — | ● Active | CMS + PDAC |
| 00409-4264-01 | Hydromorphone Hydrochloride .5 mg/.5mL INJECTION, SOLUTION | Hospira, | 10 SYRINGE in 1 CELLO PACK (0409-4264-01)... | .5 mg/.5mL | 50 | $6.80 | — | ● Active | CMS + PDAC |
| 00641-2341-41 | Hydromorphone Hydrochloride 2 mg/mL INJECTION | Hikma | 20 VIAL in 1 CARTON (0641-2341-41) / 20 m... | 2 mg/mL | 400 | $54.40 | — | ● Active | CMS + PDAC |
| 00641-6169-10 | Hydromorphone Hydrochloride 1 mg/mL INJECTION | Hikma | 10 SYRINGE in 1 CARTON (0641-6169-10) / 1... | 1 mg/mL | 100 | $13.60 | — | ● Active | CMS + PDAC |
| 00641-6206-10 | Hydromorphone Hydrochloride .5 mg/.5mL INJECTION | Hikma | 10 SYRINGE in 1 CARTON (0641-6206-10) / .... | .5 mg/.5mL | 50 | $6.80 | — | ● Active | CMS + PDAC |
| 00641-6259-10 | Hydromorphone Hydrochloride .2 mg/mL INJECTION | Hikma | 10 SYRINGE in 1 CARTON (0641-6259-10) / 1... | .2 mg/mL | 20 | $2.72 | — | ● Active | CMS + PDAC |
| 00703-0110-03 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Teva | 10 VIAL in 1 CARTON (0703-0110-03) / 1 mL... | 10 mg/mL | 1,000 | $136.00 | — | ● Active | CMS ASP |
| 63323-0851-10 | Hydromorphone Hydrochloride 10 mg/mL INJECTION, SOLUTION | Fresenius | 10 VIAL, SINGLE-DOSE in 1 CARTON (63323-85... | 10 mg/mL | 1,000 | $136.00 | — | ● Active | CMS + PDAC |
| 63323-0852-25 | Hydromorphone Hydrochloride 1 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-85... | 1 mg/mL | 250 | $34.00 | — | ● Active | CMS + PDAC |
| 63323-0854-10 | Hydromorphone Hydrochloride 4 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-85... | 4 mg/mL | 1,000 | $136.00 | — | ● Active | CMS + PDAC |
| 76045-0009-06 | Dilaudid Hydromorphone hydrochloride 1 mg/mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE in 1 CARTON (76045-009-06) / .... | 1 mg/mL | 50 | $6.80 | — | ● Active | CMS + PDAC |
| 76045-0009-11 | Dilaudid Hydromorphone hydrochloride 1 mg/mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE in 1 CARTON (76045-009-11) / 1... | 1 mg/mL | 100 | $13.60 | — | ● Active | CMS + PDAC |
| 76045-0010-11 | Dilaudid Hydromorphone hydrochloride 2 mg/mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE in 1 CARTON (76045-010-11) / 1... | 2 mg/mL | 200 | $27.20 | — | ● Active | CMS + PDAC |
| 76045-0121-11 | Dilaudid Hydromorphone hydrochloride .2 mg/mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE in 1 CARTON (76045-121-11) / 1... | .2 mg/mL | 20 | $2.72 | — | ● Active | CMS + PDAC |
| 00641-6254-01 | Hydromorphone Hydrochloride 2 mg/mL INJECTION, SOLUTION | Hikma | 1 VIAL in 1 CARTON (0641-6254-01) / 20 mL... | 2 mg/mL | 20 | $2.72 | — | ● Active | PDAC |
| 70092-0687-48 | HYDROMORPHONE HCL-SODIUM CHLORIDE 1 MG/1 ML-0.9% | Unknown | — | — | 10 | $1.36 | — | — | PDAC |
| 70092-0686-48 | HYDROMORPHONE HCL-SODIUM CHLORIDE 0.5 MG/1 ML-0.9% | Unknown | — | — | 5 | $0.68 | — | — | PDAC |
| 70092-0290-49 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.5 MG/1 ML-0.9% | Unknown | — | — | 5 | $0.68 | — | — | PDAC |
| 70092-0111-48 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9% | Unknown | — | — | 2 | $0.27 | — | — | PDAC |
| 70092-0112-49 | HYDROMORPHONE HCL-SODIUM CHLORIDE (MONOJECT SYRINGE,PF) 0.2 MG/1 ML-0.9% | Unknown | — | — | 2 | $0.27 | — | — | PDAC |
| 70092-0113-79 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9% | Unknown | — | — | 2 | $0.27 | — | — | PDAC |
| 70092-0114-50 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9% | Unknown | — | — | 2 | $0.27 | — | — | PDAC |
| 70092-0117-79 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PCA,PF,SULFITE-FREE) 1 MG/1 ML-0.9% | Unknown | — | — | 10 | $1.36 | — | — | PDAC |
| 70092-0118-50 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 1 MG/1 ML-0.9% | Unknown | — | — | 10 | $1.36 | — | — | PDAC |
| 70092-0166-48 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.2 MG/1 ML-0.9% | Unknown | — | — | 2 | $0.27 | — | — | PDAC |
| 70092-0293-49 | HYDROMORPHONE HCL-SODIUM CHLORIDE (MONOJECT BARREL,PF) 1 MG/1 ML-0.9% | Unknown | — | — | 10 | $1.36 | — | — | PDAC |
| 70092-0405-50 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 0.5 MG/1 ML-0.9% | Unknown | — | — | 5 | $0.68 | — | — | PDAC |
| 70092-0532-43 | HYDROMORPHONE HCL-SODIUM CHLORIDE (PF,SULFITE-FREE) 1 MG/1 ML-0.9% | Unknown | — | — | 10 | $1.36 | — | — | PDAC |
| 00409-2552-01 | HYDROMORPHONE HCL (USP,10X1ML) 1 MG/1 ML | Unknown | — | — | 10 | $1.36 | — | — | 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
$54.5K
Claims
1,926
Beneficiaries
746
Spend / beneficiary
$73.01
Spend / claim
$28.28
Trend by period
Where J1171 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #604 of 824
#599
ABIO XPL ABIO XPL HY... Q4355
$61.8K
#600
SODIUM CHLORIDE(J704... J7040
$60.2K
#601
FENTANYL CITRATE J3010
$57.1K
#602
LEVOTHYROXINE SODIUM... J0651
$55.4K
#603
PEMETREXED(J9314) J9314
$54.9K
#604
DILAUDID* J1171
$54.5K
#605
PROGRAF(J7521) J7521
$53.4K
#606
ARSENIC TRIOXIDE* J9017
$53K
#607
CLADRIBINE J9065
$50.6K
#608
ZALTRAP J9400
$47.2K
#609
DERMACYTE AC MATRX P... Q4343
$45.6K
Total claims — #321 of 824
#316
GLASSIA J0257
1,989
#317
SOLIRIS(J1299) J1299
1,976
#318
HERZUMA Q5113
1,968
#319
EMPLICITI J9176
1,951
#320
TOBRAMYCIN SULFATE J3260
1,945
#321
DILAUDID* J1171
1,926
#322
INVEGA SUSTENNA J2426
1,926
#323
ALBUTEROL SULFATE(J7... J7611
1,926
#324
VINCASAR PFS* J9370
1,920
#325
MITOMYCIN J9280
1,891
#326
EMTRICITABINE-TENOFO... J0750
1,859
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) | $54.5K | 746 | 1,926 | $73.01 | $28.28 |
| 2025 (Q1-Q4) | $461K | 44,981 | 60,379 | $10.25 | $7.63 |
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
$356.9K
Medicare paid
$272.3K
Submitted services
9,731,682
Denial rate
61.8%
Allowed / service
$0.10
Submitted charges
$8.09M
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 J1171 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 423,427 services across 8 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 J1171
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)
44 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.
❓ J1171 billing FAQ
What is HCPCS code J1171?
J1171 is a HCPCS Level II J-code used to bill Inj, hydromorphone, 0.1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1171?
One unit of J1171 represents 0.1 MG. Report the number of units equal to the dose administered divided by 0.1 MG.
How many units of J1171 should I bill?
Divide the dose administered by the code's unit size (0.1 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 J1171?
The Medicare Part B payment limit is $0.136 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.133 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1171?
44 NDCs currently map to J1171 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 J1171 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.