J2004 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J2004 summary

J2004 is a HCPCS Level II J-code used to bill LIDOCAINE HCL WITH EPINEPHRINE, 1 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 J2004: Lidocaine Hydrochloride And Epinephrine, Lidocaine, Xylocaine

Code J2004 NDC-Crosswalk 8 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 codeJ2004

DescriptorINJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG

Billing unitNot available in current dataset

Payment limit / unit Not available in current dataset

Mapped NDCs8

Data periodNot available in current dataset

Last updatedSource date not available

💊 About Lidocaine DRUG GUIDE

Lidocaine numbs the area where it is used.

Injectable lidocaine (for example Accucaine) is used by clinicians to numb an area or region for procedures, including nerve blocks and epidural blocks.Skin products are used for temporary relief of pain, itching, muscle soreness and minor joint pain.

They are also used for minor burns, sunburn, cuts, scrapes, insect bites, and hemorrhoid discomfort.

Some sprays and solutions (such as Dynamo Delay, INTIMALE and SKINS DELAY) are used for temporary male genital desensitization to help slow the onset of ejaculation.

Read the full Lidocaine drug guide →

Clinical overview from our editorial drug guide for Lidocaine. For billing reference, see the sections above.

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit

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Est. ASP / unit

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Est. after 2% sequester

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HCPCS dosage

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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).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J2004 = 1 unit. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (unit) 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 J2004 LEAST EXPENSIVE FIRST

8 NDCs map to J2004. Bill units = how many HCPCS units one package represents.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	NADAC / unit	Status	Source
00409-0007-10	Lidocaine Hydrochloride and Epinephrine 10 mg/mL; 10 ug/mL INJECTION, SOLUTION	Hospira,	10 VIAL, MULTI-DOSE in 1 CARTON (0409-0007...	10 mg/mL; 10 ug/mL	10	$0.139	● Active	PDAC
63323-0482-26	Xylocaine LIDOCAINE HYDROCHLORIDE,EPINEPHRINE BITARTRATE 10 mg/mL; .01 mg/mL INJECTION, SOLUTION	Fresenius	25 VIAL, MULTI-DOSE in 1 TRAY (63323-482-2...	10 mg/mL; .01 mg/mL	10	$0.272	● Active	PDAC
00409-0147-10	Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL INJECTION, SOLUTION	Hospira,	10 VIAL, MULTI-DOSE in 1 CARTON (0409-0147...	20 mg/mL; 10 ug/mL	20	—	● Active	PDAC
00362-0898-05	Lidocaine 20 mg/mL; .01 mg/mL INJECTION, SOLUTION	Septodont,	50 CARTRIDGE in 1 CARTON (0362-0898-05) /...	20 mg/mL; .01 mg/mL	20	—	● Active	PDAC
00409-1209-65	Lidocaine Hydrochloride and Epinephrine 15 mg/mL; 5 ug/mL INJECTION, SOLUTION	Hospira,	800 AMPULE in 1 CASE (0409-1209-65) / 5 m...	15 mg/mL; 5 ug/mL	15	—	● Active	PDAC
70092-0586-43	BUFFERED LIDOCAINE HCL-EPINEPHRINE 10 MCG/1 ML-0.5%	Unknown	—	—	0.01	—	—	PDAC
70092-0662-43	BUFFERED LIDOCAINE HCL-EPINEPHRINE 10 MCG/1 ML-0.5%	Unknown	—	—	0.01	—	—	PDAC
70092-0663-43	BUFFERED LIDOCAINE HCL-EPINEPHRINE 10 MCG/1 ML-1%	Unknown	—	—	0.01	—	—	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 J2004 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J2004. 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 J2004
J2002	LIDOCAINE HCL	1 MG	$0.003	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

$2.9K

Medicare paid

$2.2K

Submitted services

400,258

Denial rate

96.4%

Allowed / service

$0.20

Submitted charges

$339.9K

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 J2004 is utilized

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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 J2004

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

LIDOCAINE HYDROCHLORIDE and EPINEP... 9

Lidocaine Hydrochloride and Epinep... 2

LIDOCAINE HYDROCHLORIDE,EPINEPHRIN... 2

NDC products by labeler

Hospira, Inc. 9

Septodont, Inc. 2

Fresenius Kabi USA, LLC 2

Related NDC directory pages

🧪 All Lidocaine Hydrochloride And Epinephrine NDCsIngredient 🧪 All Lidocaine Hydrochloride And Epinephrine NDCsIngredient 🧪 All Lidocaine Hydrochloride,Epinephrine Bitartrate NDCsIngredient 🏭 All Hospira, labeler NDCsLabeler 00409 🏭 All Septodont, labeler NDCsLabeler 00362 🏭 All Fresenius labeler NDCsLabeler 63323 📚 All Amide Local Anesthetic NDCsDrug class 📚 All Antiarrhythmic NDCsDrug class 📚 All Catecholamine 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

Not available in current dataset

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Not available

NDC ↔ HCPCS crosswalk

CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)

8 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

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.

❓ J2004 billing FAQ

What is HCPCS code J2004?

J2004 is a HCPCS Level II J-code used to bill INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG under Medicare Part B and most medical (not pharmacy) benefits.

Which NDCs bill under J2004?

8 NDCs currently map to J2004 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 J2004 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.

J2004 – INJECTION, LIDOCAINE HCL WITH EPINEPHRINE, 1 MG · NDC Crosswalk & Billing Units