J1245
J1245 – Injection, dipyridamole, per 10 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 4 NDCs crosswalked per 10 MG $8.410/unit ASP+6%
📋 J1245 summary
J1245 is a HCPCS Level II J-code used to bill dipyridamole, per 10 mg, billed per 10 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Code J1245
Billing unit 10 MG Payment limit $8.410/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 codeJ1245
DescriptorInjection, dipyridamole, per 10 mg
Billing unit10 MG
Payment limit / unit$8.410
Est. ASP / unit$7.934 est.
Mapped NDCs4
Data periodQ3 2026
Last updated2026-08-20
💊 About Dipyridamole DRUG GUIDE
Dipyridamole tablets are used alongside warfarin (a blood thinner) to help prevent dangerous blood clots from forming after cardiac valve replacement surgery.
It is not used alone for this purpose — it works as an add-on to anticoagulant therapy.Dipyridamole Injection is used as an alternative to exercise during thallium myocardial perfusion imaging — a type of heart scan that checks blood flow through the coronary arteries.
It is given to patients who are unable to exercise adequately for the test.
Clinical overview from our editorial drug guide for Dipyridamole. 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
$8.410
Est. ASP / unit
$7.934 est.
Est. after 2% sequester
$8.242
HCPCS dosage
10 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, dipyridamole, per 10 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 date1998-01-01
Date added1993-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J1245 = 10 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 J1245 WITH EST. MEDICARE PAY
4 NDCs map to J1245. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($8.410/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00404-9852-10 | Dipyridamole 5 mg/mL INJECTION | Henry | 1 VIAL, SINGLE-DOSE in 1 BAG (0404-9852-10... | 5 mg/mL | 5 | $42.05 | — | ● Active | CMS ASP |
| 00641-2569-44 | Dipyridamole 5 mg/mL INJECTION | Hikma | 5 VIAL in 1 CARTON (0641-2569-44) / 10 mL... | 5 mg/mL | 25 | $210.25 | — | ● Active | CMS ASP |
| 00641-2569-41 | DIPYRIDAMOLE (SDV) 5 MG/ML | Unknown | — | — | 0.5 | $4.21 | — | — | PDAC |
| 51927-1571-00 | DIPYRIDAMOLE 1 kg/kg POWDER | Professional | 1 kg in 1 CONTAINER (51927-1571-0) | 1 kg/kg | 100 | $841.00 | — | ● 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.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$2.6K
Claims
96
Beneficiaries
96
Spend / beneficiary
$26.73
Spend / claim
$26.73
Trend by period
Where J1245 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #737 of 824
#732
LEVOFLOXACIN-D5W J1956
$2.9K
#733
CLEOCIN PHOSPHATE* J0736
$2.8K
#734
MANNITOL(J2151) J2151
$2.8K
#735
CHLOROTHIAZIDE SODIU... J1205
$2.7K
#736
AZMIRO J1072
$2.7K
#737
DIPYRIDAMOLE J1245
$2.6K
#738
PROCHLORPERAZINE EDI... J0780
$2.5K
#739
PREDNISOLONE SODIUM... J7510
$2.4K
#740
BCG (TICE STRAIN)(90... 90586
$2.4K
#741
DEXTROSE 5%-0.9% NAC... J7042
$2.4K
#742
PELLOGRAFT, PER SQ C... Q4320
$2.2K
Total claims — #635 of 824
#630
GAMASTAN J1460
100
#631
MEDROL* J7509
100
#632
PHENYLEPHRINE HCL-0.... J2371
99
#633
DILTIAZEM HCL-0.9% N... J1163
97
#634
FOSCARNET SODIUM J1455
97
#635
DIPYRIDAMOLE J1245
96
#636
PFIZER COVID (6M-4... 91318
95
#637
REBYOTA J1440
95
#638
DIHYDROERGOTAMINE ME... J1110
94
#639
ELFABRIO J2508
94
#640
OMVOH PEN* J2267
90
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) | $2.6K | 96 | 96 | $26.73 | $26.73 |
| 2025 (Q1-Q4) | $45K | 2,434 | 2,464 | $18.50 | $18.27 |
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
$45.5K
Medicare paid
$35.6K
Submitted services
14,110
Denial rate
18.4%
Allowed / service
$3.95
Submitted charges
$347.5K
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 J1245 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 24,663 services across 18 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 J1245
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)
4 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.
❓ J1245 billing FAQ
What is HCPCS code J1245?
J1245 is a HCPCS Level II J-code used to bill Injection, dipyridamole, per 10 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1245?
One unit of J1245 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of J1245 should I bill?
Divide the dose administered by the code's unit size (10 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 J1245?
The Medicare Part B payment limit is $8.410 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $8.242 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1245?
4 NDCs currently map to J1245 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 J1245 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.