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J1322

J1322 – Injection, elosulfase alfa, 1 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 1 MG $319.517/unit ASP+6%

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J1322 summary

J1322 is a HCPCS Level II J-code used to bill elosulfase alfa, 1 mg, 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 J1322: Vimizim

Code J1322 Billing unit 1 MG Payment limit $319.517/unit NDC-Crosswalk 1 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 codeJ1322
DescriptorInjection, elosulfase alfa, 1 mg
Billing unit1 MG
Payment limit / unit$319.517
Est. ASP / unit$301.431 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20

🧾 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
$319.517
Est. ASP / unit
$301.431 est.
Est. after 2% sequester
$313.127
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.
Full HCPCS code details (official CMS record)
Long descriptionInjection, elosulfase alfa, 1 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2015-01-01
Date added2015-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1322 = 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 J1322 WITH EST. MEDICARE PAY

1 NDC map to J1322. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($319.517/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
68135-0100-01 elosulfase alfa 5 mg/5mL INJECTION, SOLUTION, CONCENTRATE BioMarin 1 VIAL in 1 CARTON (68135-100-01) / 5 mL... 5 mg/5mL 5 $1,597.59 — ● Active CMS ASP
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
$888.2K
Claims
14
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$63,444.58
Where J1322 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #570 of 918
#565 AMNIOCORE PER SQ CM*... Q4227 $955K #566 BENDAMUSTINE HCL* J9033 $919.9K #567 LEUKINE J2820 $917.4K #568 APLIGRAF Q4101 $914.9K #569 FLUDARABINE PHOSPHAT... J9185 $893.2K #570 VIMIZIM J1322 $888.2K #571 KHAPZORY J0642 $844.4K #572 OPTISON Q9956 $825.1K #573 THERASKIN** Q4121 $814.9K #574 TROGARZO J1746 $814.1K #575 AMNIOEXCEL BIODEXCEL... Q4137 $806.3K
Total claims — #910 of 918
#905 VASOPRESSIN* J2598 16 #906 GRAFIX CORE, GRAFIXP... Q4132 16 #907 PHENYTOIN SODIUM J1165 15 #908 WOUNDFIX BIOWOUND PL... Q4217 15 #909 ACETAMINOPHEN(J0134) J0134 14 #910 VIMIZIM J1322 14 #911 CHLORPROMAZINE HCL J3230 14 #912 CEFAZOLIN SODIUM-DEX... J0689 13 #913 FIRAZYR* J1744 13 #914 PARICALCITOL* J2501 11 #915 THROMBATE III J7197 11

Full breakdown by period (1)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2025 (Q1-Q4) $888.2K — 14 — $63,444.58
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.

🗺️ Where J1322 is utilized

⏳
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.

🗃️ 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
1 NDC 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.

❓ J1322 billing FAQ

What is HCPCS code J1322?
J1322 is a HCPCS Level II J-code used to bill Injection, elosulfase alfa, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1322?
One unit of J1322 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J1322 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 J1322?
The Medicare Part B payment limit is $319.517 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $313.127 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1322?
1 NDC currently map to J1322 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 J1322 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.