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J1951

J1951 – Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing

J-code ● 2 NDCs crosswalked per 0.25 MG $145.311/unit ASP+6%

This page is curated, coded, and maintained by Dr. Brian Staiger, PharmD

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

📋 J1951 summary

J1951 is a HCPCS Level II J-code used to bill leuprolide acetate for depot suspension (fensolvi), 0.25 mg, billed per 0.25 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 J1951: Fensolvi

Code J1951 Billing unit 0.25 MG Payment limit $145.311/unit NDC-Crosswalk 2 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 codeJ1951

DescriptorInjection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg

Billing unit0.25 MG

Payment limit / unit$145.311

Est. ASP / unit$137.086 est.

Mapped NDCs2

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

$145.311

Est. ASP / unit

$137.086 est.

Est. after 2% sequester

$142.405

HCPCS dosage

0.25 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, leuprolide acetate for depot suspension (fensolvi), 0.25 mg

CoverageC — Carrier/MAC judgment

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 date2021-07-01

Date added2021-07-01

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

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1951 = 0.25 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 J1951 WITH EST. MEDICARE PAY

2 NDCs map to J1951. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($145.311/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
62935-0153-50	Fensolvi Leuprolide Acetate KIT	TOLMAR	1 KIT in 1 CARTON (62935-153-50) * .375...	—	180	$26,155.98	—	● Active	CMS ASP
62935-0163-60	Fensolvi Leuprolide Acetate 45 mg/.375mL INJECTION, SUSPENSION, EXTENDED RELEASE	TOLMAR	1 SYRINGE in 1 CARTON (62935-163-60) / .3...	45 mg/.375mL	180	$26,155.98	—	● 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.

⚠️ Don't confuse J1951 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J1951. 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 J1951
J9217	Leuprolide acetate suspnsion	7.5 MG	$160.342	Different billing unit — 7.5 MG vs 0.25 MG
J1952	Leuprolide inj, camcevi, 1mg	1 mg	$42.059	Different billing unit — 1 mg vs 0.25 MG
J1950	Leuprolide acetate /3.75 mg	3.75 MG	$1,841.261	Different billing unit — 3.75 MG vs 0.25 MG
J1954	Leuprolide depot cipla 7.5mg	7.5 MG	$687.287	Different billing unit — 7.5 MG vs 0.25 MG

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

No reportable public Medicare utilization was found for J1951. This is expected for newer codes, low-volume drugs, or codes whose use is billed under another code. CMS also hides any figure covering fewer than 11 patients (a privacy rule), so small-volume use may exist but isn't publishable. Utilization and spend appear here automatically once CMS publishes reportable data for this code.

🗃️ 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

2 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.

❓ J1951 billing FAQ

What is HCPCS code J1951?

J1951 is a HCPCS Level II J-code used to bill Injection, leuprolide acetate for depot suspension (fensolvi), 0.25 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J1951?

One unit of J1951 represents 0.25 MG. Report the number of units equal to the dose administered divided by 0.25 MG.

How many units of J1951 should I bill?

Divide the dose administered by the code's unit size (0.25 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 J1951?

The Medicare Part B payment limit is $145.311 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $142.405 per unit. Payment limits are revised quarterly.

Which NDCs bill under J1951?

2 NDCs currently map to J1951 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 J1951 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.