J1811 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J1811 summary

J1811 is a HCPCS Level II J-code used to bill Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units, billed per 50 UNITS. 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 J1811: Fiasp Pumpcart*, Fiasp

Code J1811 Billing unit 50 UNITS Payment limit $1.727/unit NDC-Crosswalk 3 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 codeJ1811

DescriptorInsulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units

Billing unit50 UNITS

Payment limit / unit$1.727

Est. ASP / unit$1.629 est.

Mapped NDCs3

Data periodQ3 2026

Last updated2026-08-20

💊 About Insulin Aspart (rDNA Origin) Injection DRUG GUIDE

Insulin aspart is used to improve blood sugar (glucose) control in people with diabetes mellitus.

It is approved for both type 1 and type 2 diabetes in adults, and for diabetes mellitus in pediatric patients.Insulin Aspart Protamine and Insulin Aspart Mix 70/30 is a pre-mixed product that combines a rapid-acting and an intermediate-acting insulin aspart.

It is approved to improve blood sugar control in adult patients with diabetes mellitus.

It is not recommended for treating diabetic ketoacidosis, and because its ratio of rapid-acting to intermediate-acting insulin is fixed, it does not allow for separate mealtime versus background dose adjustments.

Read the full Insulin Aspart (rDNA Origin) Injection drug guide →

Clinical overview from our editorial drug guide for Insulin Aspart (rDNA Origin) 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

$1.727

Est. ASP / unit

$1.629 est.

Est. after 2% sequester

$1.692

HCPCS dosage

50 UNITS

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 descriptionInsulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units

CoverageC — Carrier/MAC judgment

Pricing indicator51 — Drug — priced under the ASP methodology

Type of serviceP — Drug administered (Part B)

BETOS-2D1G

ASC payment groupYY

Action codeP — Payment change

Effective date2024-01-01

Date added2023-07-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1811 = 50 units. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (units) Frequency — every days Number of doses NDC / package billed (optional)

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 J1811 LEAST EXPENSIVE FIRST

3 NDCs map to J1811. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.727/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00169-3201-11	Fiasp insulin aspart injection 100 [iU]/mL INJECTION, SOLUTION	Novo	1 VIAL, GLASS in 1 CARTON (0169-3201-11)...	100 [iU]/mL	20	$34.54	$6.925	● Active	CMS + PDAC
00169-3206-15	Fiasp insulin aspart 100 [iU]/mL INJECTION, SOLUTION	Novo	5 CARTRIDGE in 1 CARTON (0169-3206-15) /...	100 [iU]/mL	16	$27.63	$8.573	● Active	CMS + PDAC
00169-3206-11	FIASP PUMPCART (1X1.6ML CARTRIDGE) 100 U/1 ML	Unknown	—	—	2	$3.45	—	—	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.

⚠️ Don't confuse J1811 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J1811. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J1811
J1817	Insulin for insulin pump use	50 UNITS	$3.062	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J1813	Lyumjev for insulin pump use	50 UNITS	$4.802	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$460.5K

Claims

1,343

Beneficiaries

865

Spend / beneficiary

$532.35

Spend / claim

$342.88

Trend by period

Where J1811 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #449 of 824

#444 BIO-CONNEKT PER SQUA... Q4161 $490.4K #445 ALPHANATE J7186 $474.9K #446 EPICORD 1 SQ CM** Q4187 $473.8K #447 GEMCITABINE HCL(J920... J9201 $466.6K #448 BERINERT J0597 $461.9K #449 FIASP PUMPCART* J1811 $460.5K #450 AMNIOEXCEL BIODEXCEL... Q4137 $457.8K #451 RENOGRAFT, PER SQ CM... Q4321 $456.2K #452 ESPEROCT J7204 $454.6K #453 ALPHANINE SD J7193 $450K #454 CYCLOSPORINE MODIFIE... J7502 $434.7K

Total claims — #350 of 824

#345 WOUND MATRIX Q4102 1,391 #346 ALBUKED-25(P9046)* P9046 1,387 #347 MYOBLOC J0587 1,378 #348 HEMLIBRA J7170 1,352 #349 BAVENCIO J9023 1,352 #350 FIASP PUMPCART* J1811 1,343 #351 ALYGLO J1552 1,305 #352 DEXTROSE 5%-0.9% NAC... J7042 1,276 #353 MORPHINE SULFATE(J22... J2270 1,262 #354 RIMSO-50 J1212 1,256 #355 NIKTIMVO J9038 1,223

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$460.5K	865	1,343	$532.35	$342.88
2025 (Q1-Q4)	$1.87M	1,396	5,337	$1,341.83	$350.98

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

$1.91M

Medicare paid

$1.67M

Submitted services

255,335

Denial rate

2.3%

Allowed / service

$7.66

Submitted charges

$8.19M

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 J1811 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.

📊 What bills under J1811

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

insulin aspart injection 1

insulin aspart 1

NDC products by labeler

Novo Nordisk 2

🔗 Related NDC directory pages

🧪 All Insulin Aspart Injection NDCsIngredient 🧪 All Insulin Aspart NDCsIngredient 🏭 All Novo labeler NDCsLabeler 00169 📚 All Insulin Analog NDCsDrug class

🗃️ 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)

3 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.

❓ J1811 billing FAQ

What is HCPCS code J1811?

J1811 is a HCPCS Level II J-code used to bill Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J1811?

One unit of J1811 represents 50 UNITS. Report the number of units equal to the dose administered divided by 50 UNITS.

How many units of J1811 should I bill?

Divide the dose administered by the code's unit size (50 UNITS) 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 J1811?

The Medicare Part B payment limit is $1.727 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.692 per unit. Payment limits are revised quarterly.

Which NDCs bill under J1811?

3 NDCs currently map to J1811 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 J1811 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.

J1811 – Insulin (fiasp) for administration through dme (i.e., insulin pump) per · NDC Crosswalk & Billing Units