J1921 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J1921 summary

J1921 is a HCPCS Level II J-code used to bill labetalol hydrochloride (hikma) not therapeutically equivalent to j1920, 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 J1921: Labetalol Hcl In Sodium Chloride, Labetalol Hcl In Dextrose

Code J1921 Billing unit 5 MG Payment limit $0.906/unit NDC-Crosswalk 6 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 codeJ1921

DescriptorInjection, labetalol hydrochloride (hikma) not therapeutically equivalent to j1920, 5 mg

Billing unit5 MG

Payment limit / unit$0.906

Est. ASP / unit$0.855 est.

Mapped NDCs6

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

$0.906

Est. ASP / unit

$0.855 est.

Est. after 2% sequester

$0.888

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 (hikma) not therapeutically equivalent to j1920, 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 J1921 = 5 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) 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 J1921 WITH EST. MEDICARE PAY

6 NDCs map to J1921. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.906/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00143-9183-10	Labetalol Hydrochloride 5 mg/mL INJECTION, SOLUTION	Hikma	10 VIAL in 1 CARTON (0143-9183-10) / 4 mL...	5 mg/mL	40	$36.24	—	● Active	CMS + PDAC
00641-6252-10	Labetalol HCl	Hikma	—	—	20	$18.12	—	—	CMS + PDAC
00143-9363-10	Labetalol HCl in Sodium Chloride LABETALOL HYDROCHLORIDE 1 mg/mL INJECTION	Hikma	10 BAG in 1 BOX (0143-9363-10) / 100 mL i...	1 mg/mL	0.2	$0.18	—	● Active	PDAC
00143-9364-10	Labetalol HCl in Sodium Chloride LABETALOL HYDROCHLORIDE 1 mg/mL INJECTION	Hikma	10 BAG in 1 BOX (0143-9364-10) / 200 mL i...	1 mg/mL	0.2	$0.18	—	● Active	PDAC
00143-9365-10	Labetalol HCl in Sodium Chloride LABETALOL HYDROCHLORIDE 1 mg/mL INJECTION	Hikma	10 BAG in 1 BOX (0143-9365-10) / 300 mL i...	1 mg/mL	0.2	$0.18	—	● Active	PDAC
00143-9366-10	Labetalol HCl in Dextrose Labetalol Hydrochloride 1 mg/mL INJECTION	Hikma	10 BAG in 1 BOX (0143-9366-10) / 200 mL i...	1 mg/mL	0.2	$0.18	—	● Active	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 J1921 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J1921. 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 J1921
J1920	Inj, labetalol hcl, 5mg	5 MG	$0.218	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 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

$0.00

Medicare paid

$1.08

Submitted services

60

Denial rate

100.0%

Submitted charges

$67.20

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 J1921

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 3

Labetalol Hydrochloride 2

NDC products by labeler

Hikma Pharmaceuticals USA Inc. 5

🔗 Related NDC directory pages

🧪 All Labetalol Hydrochloride NDCsIngredient 🧪 All Labetalol Hydrochloride NDCsIngredient 🏭 All Hikma labeler NDCsLabeler 00143 📚 All beta-Adrenergic Blocker 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)

6 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

No reportable utilization

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.

❓ J1921 billing FAQ

What is HCPCS code J1921?

J1921 is a HCPCS Level II J-code used to bill Injection, labetalol hydrochloride (hikma) not therapeutically equivalent to j1920, 5 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J1921?

One unit of J1921 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.

How many units of J1921 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 J1921?

The Medicare Part B payment limit is $0.906 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.888 per unit. Payment limits are revised quarterly.

Which NDCs bill under J1921?

6 NDCs currently map to J1921 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 J1921 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.

J1921 – Injection, labetalol hydrochloride (hikma) not therapeutically equivalen · NDC Crosswalk & Billing Units