J1645
J1645 – Injection, dalteparin sodium, per 2500 iu · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 9 NDCs crosswalked per 2500 IU $48.413/unit ASP+6%
📋 J1645 summary
J1645 is a HCPCS Level II J-code used to bill dalteparin sodium, per 2500 iu, billed per 2500 IU. 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 J1645: Fragmin
Code J1645
Billing unit 2500 IU Payment limit $48.413/unit NDC-Crosswalk 9
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 codeJ1645
DescriptorInjection, dalteparin sodium, per 2500 iu
Billing unit2500 IU
Payment limit / unit$48.413
Est. ASP / unit$45.673 est.
Mapped NDCs9
Data periodQ3 2026
Last updated2026-08-20
💊 About Dalteparin Injection DRUG GUIDE
Fragmin (dalteparin) injection is used to prevent blood clots (deep vein thrombosis and pulmonary embolism) in patients having abdominal surgery, hip replacement surgery, or in medical patients who are severely immobile during a serious illness.
It is also used to reduce the risk of dangerous complications from unstable angina and a type of heart attack called non-Q-wave myocardial infarction, given alongside aspirin.Fragmin is also used for the extended treatment of symptomatic venous thromboembolism (VTE — blood clots in the veins or lungs) to prevent recurrence in adult cancer patients, and for the treatment of symptomatic VTE in children from birth (gestational age at least 35 weeks).
Fragmin is not intended for the immediate (acute) treatment of VTE.
Clinical overview from our editorial drug guide for Dalteparin 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
$48.413
Est. ASP / unit
$45.673 est.
Est. after 2% sequester
$47.445
HCPCS dosage
2500 IU
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, dalteparin sodium, per 2500 iu
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 date2002-07-01
Date added1997-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J1645 = 2,500 iu. 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 J1645 WITH EST. MEDICARE PAY
9 NDCs map to J1645. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($48.413/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00069-0195-02 | Fragmin Dalteparin Sodium 2500 [iU]/.2mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0195-02) / .... | 2500 [iU]/.2mL | 10 | $484.13 | — | ● Active | CMS + PDAC |
| 00069-0196-02 | Fragmin Dalteparin Sodium 5000 [iU]/.2mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0196-02) / .... | 5000 [iU]/.2mL | 20 | $968.26 | — | ● Active | CMS + PDAC |
| 00069-0206-02 | Fragmin Dalteparin Sodium 7500 [iU]/.3mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0206-02) / .... | 7500 [iU]/.3mL | 30 | $1,452.39 | — | ● Active | CMS + PDAC |
| 00069-0217-02 | Fragmin Dalteparin Sodium 10000 [iU]/mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0217-02) / 1... | 10000 [iU]/mL | 40 | $1,936.52 | — | ● Active | CMS + PDAC |
| 00069-0220-02 | Fragmin Dalteparin Sodium 12500 [iU]/.5mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0220-02) / .... | 12500 [iU]/.5mL | 50 | $2,420.65 | — | ● Active | CMS + PDAC |
| 00069-0223-02 | Fragmin Dalteparin Sodium 15000 [iU]/.6mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0223-02) / .... | 15000 [iU]/.6mL | 60 | $2,904.78 | — | ● Active | CMS + PDAC |
| 00069-0228-02 | Fragmin Dalteparin Sodium 18000 [iU]/.72mL INJECTION | Pfizer | 10 SYRINGE in 1 CARTON (0069-0228-02) / .... | 18000 [iU]/.72mL | 72 | $3,485.74 | — | ● Active | CMS + PDAC |
| 00069-0232-01 | Fragmin Dalteparin Sodium 25000 [iU]/mL INJECTION | Pfizer | 1 VIAL, MULTI-DOSE in 1 CARTON (0069-0232-... | 25000 [iU]/mL | 38 | $1,839.69 | — | ● Active | CMS + PDAC |
| 00069-0253-10 | Fragmin Dalteparin Sodium 2500 [iU]/mL INJECTION | Pfizer | 10 VIAL, SINGLE-DOSE in 1 CARTON (0069-025... | 2500 [iU]/mL | 40 | $1,936.52 | — | ● 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
$3.8K
Claims
56
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$67.57
Where J1645 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #848 of 918
#843
LIDOCAINE HCL IN 5%... J2002
$4.4K
#844
VFEND IV* J3465
$4.3K
#845
BUTORPHANOL TARTRATE J0595
$4.1K
#846
ERAXIS J0348
$4.1K
#847
METOCLOPRAMIDE HCL J2765
$4K
#848
FRAGMIN J1645
$3.8K
#849
MEDROL* J7509
$3.7K
#850
FLUMIST * 90660
$3.7K
#851
RUCONEST J0596
$3.6K
#852
CIPROFLOXACIN-D5W J0744
$3.6K
#853
VANCOMYCIN HCL(J3374... J3374
$3.5K
Total claims — #837 of 918
#832
BREVIBLOC* J1805
65
#833
NOVOEIGHT J7182
63
#834
AMNIOCORE PER SQ CM*... Q4227
63
#835
ABECMA Q2055
61
#836
BIOVANCE 1 SQUARE CM... Q4154
57
#837
FRAGMIN J1645
56
#838
ARIXTRA* J1652
56
#839
TEPADINA(J9340)* J9340
56
#840
TEPADINA(J9342)* J9342
54
#841
DEXAMETHASONE INTENS... J8540
53
#842
CANCIDAS* J0637
52
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) | $3.8K | — | 56 | — | $67.57 |
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
$3.4K
Medicare paid
$3.2K
Submitted services
986
Denial rate
76.6%
Allowed / service
$14.84
Submitted charges
$106.1K
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 J1645
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)
9 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.
❓ J1645 billing FAQ
What is HCPCS code J1645?
J1645 is a HCPCS Level II J-code used to bill Injection, dalteparin sodium, per 2500 iu under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1645?
One unit of J1645 represents 2500 IU. Report the number of units equal to the dose administered divided by 2500 IU.
How many units of J1645 should I bill?
Divide the dose administered by the code's unit size (2500 IU) 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 J1645?
The Medicare Part B payment limit is $48.413 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $47.445 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1645?
9 NDCs currently map to J1645 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 J1645 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.