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J1920

J1920 – Injection, labetalol hydrochloride, 5 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 30 NDCs crosswalked per 5 MG $0.218/unit ASP+6%

📋 J1920 summary

J1920 is a HCPCS Level II J-code used to bill labetalol hydrochloride, 5 mg, billed per 5 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 J1920: Labetalol Hydrochloride

Code J1920 Billing unit 5 MG Payment limit $0.218/unit NDC-Crosswalk 30 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 codeJ1920
DescriptorInjection, labetalol hydrochloride, 5 mg
Billing unit5 MG
Payment limit / unit$0.218
Est. ASP / unit$0.206 est.
Mapped NDCs30
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
$0.218
Est. ASP / unit
$0.206 est.
Est. after 2% sequester
$0.214
HCPCS dosage
5 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, labetalol hydrochloride, 5 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
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 J1920 = 5 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 J1920 LEAST EXPENSIVE FIRST

30 NDCs map to J1920. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.218/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
00143-9320-01 Labetalol Hydrochloride 5 mg/mL INJECTION Hikma 1 VIAL in 1 BOX, UNIT-DOSE (0143-9320-01)... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
00143-9622-01 Labetalol Hydrochloride 5 mg/mL INJECTION Hikma 1 VIAL in 1 BOX, UNIT-DOSE (0143-9622-01)... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
25021-0317-20 labetalol hydrochloride 5 mg/mL INJECTION, SOLUTION Sagent 1 VIAL in 1 CARTON (25021-317-20) / 20 mL... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
36000-0322-02 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Baxter 1 VIAL in 1 CARTON (36000-322-02) / 20 mL... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
65145-0124-01 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Caplin 1 VIAL, MULTI-DOSE in 1 CARTON (65145-124-... 5 mg/mL 20 $4.36 $0.202 ● Active CMS ASP
72266-0102-01 Labetalol Hydrochloride 5 mg/mL INJECTION Fosun 1 VIAL, MULTI-DOSE in 1 CARTON (72266-102-... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
72572-0350-01 Labetalol Hydrochloride 5 mg/mL INJECTION Civica, 1 VIAL in 1 BOX, UNIT-DOSE (72572-350-01)... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
72603-0146-01 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION NorthStar 1 VIAL, MULTI-DOSE in 1 CARTON (72603-146-... 5 mg/mL 20 $4.36 $0.202 ● Active CMS + PDAC
00143-9623-01 Labetalol Hydrochloride 5 mg/mL INJECTION Hikma 1 VIAL in 1 BOX, UNIT-DOSE (0143-9623-01)... 5 mg/mL 40 $8.72 ● Active CMS + PDAC
00409-0125-25 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Hospira, 25 VIAL, MULTI-DOSE in 1 TRAY (0409-0125-2... 5 mg/mL 500 $109.00 ● Active CMS + PDAC
00409-2267-54 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Hospira, 1 VIAL, MULTI-DOSE in 1 CARTON (0409-2267-... 5 mg/mL 40 $8.72 Obsolete CMS + PDAC
00409-2339-34 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Hospira, 10 CARTON in 1 PACKAGE (0409-2339-34) / 1... 5 mg/mL 40 $8.72 ● Active CMS ASP
25021-0317-40 labetalol hydrochloride 5 mg/mL INJECTION, SOLUTION Sagent 1 VIAL in 1 CARTON (25021-317-40) / 40 mL... 5 mg/mL 40 $8.72 ● Active CMS + PDAC
36000-0320-10 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Baxter 10 VIAL in 1 CARTON (36000-320-10) / 4 mL... 5 mg/mL 40 $8.72 ● Active CMS + PDAC
36000-0324-02 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Baxter 1 VIAL in 1 CARTON (36000-324-02) / 40 mL... 5 mg/mL 40 $8.72 ● Active CMS + PDAC
51662-1228-01 Labetalol HCl HF 20 $4.36 CMS ASP
51662-1602-01 LABETALOL HCl 5 mg/mL INJECTION HF 1 VIAL in 1 BOX, UNIT-DOSE (51662-1602-1)... 5 mg/mL 20 $4.36 ● Active CMS ASP
51662-1602-09 LABETALOL HCl 5 mg/mL INJECTION HF 20 mL in 1 VIAL (51662-1602-9) 5 mg/mL 20 $4.36 ● Active CMS ASP
65145-0125-01 Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION Caplin 1 VIAL, MULTI-DOSE in 1 CARTON (65145-125-... 5 mg/mL 40 $8.72 ● Active CMS ASP
70121-2428-03 LABETALOL HYDROCHLORIDE 5 mg/mL INJECTION, SOLUTION Amneal 24 CARTON in 1 CARTON (70121-2428-3) / 1... 5 mg/mL 96 $20.93 ● Active CMS + PDAC
72266-0103-01 Labetalol Hydrochloride 5 mg/mL INJECTION Fosun 1 VIAL, MULTI-DOSE in 1 CARTON (72266-103-... 5 mg/mL 40 $8.72 ● Active CMS + PDAC
72266-0103-41 Labetalol Hydrochloride 5 mg/mL INJECTION Fosun 1 VIAL, MULTI-DOSE in 1 CARTON (72266-103-... 5 mg/mL 40 $8.72 ● Active CMS ASP
72611-0734-01 Labetalol HCl Almaject, 20 $4.36 CMS + PDAC
72611-0738-01 Labetalol HCl Almaject, 40 $8.72 CMS + PDAC
69374-0946-34 LABETALOL HCL (PF) 5 MG/1 ML Unknown 1 $0.22 PDAC
69374-0946-04 LABETALOL HCL (PF,LATEX-FREE) 5 MG/1 ML Unknown 1 $0.22 PDAC
70092-0009-44 LABETALOL HCL (5ML SYRINGE) 5 MG/1 ML Unknown 1 $0.22 PDAC
47781-0586-56 LABETALOL HCL (USP,MDV,LATEX-FREE) 5 MG/1 ML Unknown 1 $0.22 PDAC
47781-0586-29 LABETALOL HCL (USP,MDV,LATEX-FREE) 5 MG/1 ML Unknown 1 $0.22 PDAC
00409-2267-20 LABETALOL HCL (USP,MDV) 5 MG/1 ML Unknown 1 $0.22 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
$273.36
Claims
53
Beneficiaries
49
Spend / beneficiary
$5.58
Spend / claim
$5.16
Trend by period
Where J1920 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $273.36 49 53 $5.58 $5.16
2025 (Q1-Q4) $1.1K 260 327 $4.39 $3.49
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
$389.70
Medicare paid
$376.83
Submitted services
3,092
Denial rate
62.7%
Allowed / service
$0.34
Submitted charges
$29.8K
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 J1920 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 438 services across 5 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 J1920

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
Labetalol Hydrochloride 15
labetalol hydrochloride 2
NDC products by labeler
Hospira, Inc. 4
Hikma Pharmaceuticals USA Inc. 3
Baxter Healthcare Corporation 3
Fosun Pharma USA Inc. 3
Sagent Pharmaceuticals 1
Amneal Pharmaceuticals LLC 1
Civica, Inc. 1
NorthStar Rx LLC 1

🗃️ 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)
30 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.

J1920 billing FAQ

What is HCPCS code J1920?
J1920 is a HCPCS Level II J-code used to bill Injection, labetalol hydrochloride, 5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J1920?
One unit of J1920 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.
How many units of J1920 should I bill?
Divide the dose administered by the code's unit size (5 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 J1920?
The Medicare Part B payment limit is $0.218 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.214 per unit. Payment limits are revised quarterly.
Which NDCs bill under J1920?
30 NDCs currently map to J1920 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 J1920 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.