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J1455

J1455 – Injection, foscarnet sodium, per 1000 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 5 NDCs crosswalked per 1000 MG $8.355/unit ASP+6%

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

📋 J1455 summary

J1455 is a HCPCS Level II J-code used to bill foscarnet sodium, per 1000 mg, billed per 1000 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 J1455: Foscarnet

Code J1455 Billing unit 1000 MG Payment limit $8.355/unit NDC-Crosswalk 5 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 codeJ1455
DescriptorInjection, foscarnet sodium, per 1000 mg
Billing unit1000 MG
Payment limit / unit$8.355
Est. ASP / unit$7.882 est.
Mapped NDCs5
Data periodQ3 2026
Last updated2026-09-20

🧾 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
$8.355
Est. ASP / unit
$7.882 est.
Est. after 2% sequester
$8.188
HCPCS dosage
1000 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, foscarnet sodium, per 1000 mg
CoverageD — Special coverage instructions apply
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 date2017-01-01
Date added1993-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1455 = 1,000 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 J1455 WITH EST. MEDICARE PAY

5 NDCs map to J1455. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($8.355/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
00143-9192-01 Foscarnet Sodium 24 mg/mL INJECTION, SOLUTION Hikma 10 CARTON in 1 CASE (0143-9192-01) / 1 BO... 24 mg/mL 60 $501.30 — ● Active CMS ASP
25021-0189-84 Foscarnet Sodium 24 mg/mL INJECTION, SOLUTION Sagent 10 BAG in 1 CARTON (25021-189-84) / 250 m... 24 mg/mL 60 $501.30 — ● Active CMS ASP
43066-0089-10 FOSCARNET SODIUM 6000 mg/250mL INJECTION, SOLUTION Baxter 10 BAG in 1 CARTON (43066-089-10) / 250 m... 6000 mg/250mL 60 $501.30 — ● Active CMS ASP
63323-0875-50 Foscarnet 24 mg/mL INJECTION, SOLUTION Fresenius 1 BOTTLE in 1 CARTON (63323-875-50) / 250... 24 mg/mL 6 $50.13 — ● Active CMS ASP
70121-1744-02 Foscarnet Sodium 24 mg/mL INJECTION Amneal 12 POUCH in 1 CARTON (70121-1744-2) / 1 B... 24 mg/mL 72 $601.56 — ● 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 · 2026 (Q1)

Period
Total Part B spend
$12.6K
Claims
97
Beneficiaries
23
Spend / beneficiary
$546.28
Spend / claim
$129.53
Trend by period
Where J1455 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #676 of 824
#671 MULTIHANCE MULTIPACK A9578 $13.7K #672 FLUDARABINE PHOSPHAT... J9185 $13.6K #673 MICAFUNGIN(J2248)* J2248 $13.4K #674 CORTROSYN* J0834 $13.2K #675 IMIPENEM-CILASTATIN... J0743 $13.1K #676 FOSCARNET SODIUM J1455 $12.6K #677 SURGRAFT XT PER SQ C... Q4269 $12.3K #678 TOBRAMYCIN SULFATE J3260 $12.3K #679 PHENERGAN* J2550 $12.2K #680 IFEX* J9208 $11.9K #681 NAROPIN* J2795 $11.7K
Total claims — #634 of 824
#629 DERMABIND FM, PER SQ... Q4313 102 #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

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $12.6K 23 97 $546.28 $129.53
2025 (Q1-Q4) $172K 105 568 $1,638.16 $302.83
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
$103.7K
Medicare paid
$82.9K
Submitted services
5,584
Denial rate
12.8%
Allowed / service
$21.30
Submitted charges
$1.6M
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 J1455 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 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
5 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.

❓ J1455 billing FAQ

What is HCPCS code J1455?
J1455 is a HCPCS Level II J-code used to bill Injection, foscarnet sodium, per 1000 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1455?
One unit of J1455 represents 1000 MG. Report the number of units equal to the dose administered divided by 1000 MG.
How many units of J1455 should I bill?
Divide the dose administered by the code's unit size (1000 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 J1455?
The Medicare Part B payment limit is $8.355 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $8.188 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1455?
5 NDCs currently map to J1455 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 J1455 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.