J2247
J2247 – Injection, micafungin sodium (par pharm) not thereapeutically equivalent · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 1 MG $0.219/unit ASP+6%
📋 J2247 summary
J2247 is a HCPCS Level II J-code used to bill micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg, billed per 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 J2247: Micafungin(J2247), Micafungin
Code J2247
Billing unit 1 MG Payment limit $0.219/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 codeJ2247
DescriptorInjection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
Billing unit1 MG
Payment limit / unit$0.219
Est. ASP / unit$0.207 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20
💊 About Micafungin DRUG GUIDE
Micafungin is used to treat several serious infections caused by Candida (a type of yeast), including candidemia (Candida in the bloodstream), acute disseminated candidiasis (widespread Candida infection), Candida peritonitis (Candida infection in the abdomen), Candida abscesses, and esophageal candidiasis (Candida infection of the esophagus/swallowing tube).
These uses apply to adults and most pediatric patients.Micafungin is also used to prevent Candida infections in adults and pediatric patients 4 months of age and older who are undergoing hematopoietic stem cell transplantation (HSCT).
Micafungin in Sodium Chloride Injection is only appropriate when a dose of exactly 50 mg, 100 mg, or 150 mg is needed; if a different dose is required, an alternative micafungin formulation should be used.
Clinical overview from our editorial drug guide for Micafungin. 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
$0.219
Est. ASP / unit
$0.207 est.
Est. after 2% sequester
$0.215
HCPCS dosage
1 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, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 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 added2023-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J2247 = 1 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 J2247 WITH EST. MEDICARE PAY
2 NDCs map to J2247. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.219/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 42023-0229-10 | Micafungin 10 mg/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Par | 10 VIAL, SINGLE-DOSE in 1 CARTON (42023-22... | 10 mg/mL | 500 | $109.50 | — | Obsolete | CMS + PDAC |
| 42023-0230-10 | Micafungin 20 mg/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Par | 10 VIAL, SINGLE-DOSE in 1 CARTON (42023-23... | 20 mg/mL | 1,000 | $219.00 | — | Obsolete | CMS + 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
$819.12
Claims
39
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$21.00
Trend by period
Where J2247 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #777 of 824
#772
TIGECYCLINE* J3243
$940.10
#773
METRO IV* J1836
$932.49
#774
BUTORPHANOL TARTRATE J0595
$881.00
#775
PHYTONADIONE* J3430
$874.12
#776
AMPICILLIN SODIUM J0290
$832.24
#777
MICAFUNGIN(J2247) J2247
$819.12
#778
DEXTROSE IN WATER(J7... J7070
$808.79
#779
METOCLOPRAMIDE HCL J2765
$769.16
#780
BENZTROPINE MESYLATE J0515
$656.40
#781
CIPROFLOXACIN-D5W J0744
$605.35
#782
PROTAMINE SULFATE J2720
$543.58
Total claims — #717 of 824
#712
BIOVANCE 1 SQUARE CM... Q4154
42
#713
VITOGRAFT, PER SQ CM... Q4317
42
#714
ELELYSO J3060
41
#715
FEIBA J7198
40
#716
ERAXIS J0348
39
#717
MICAFUNGIN(J2247) J2247
39
#718
PHYTONADIONE* J3430
39
#719
MITOXANTRONE HCL J9293
39
#720
RUCONEST J0596
38
#721
CHLOROTHIAZIDE SODIU... J1205
38
#722
FLUCONAZOLE-NACL J1450
38
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $819.12 | — | 39 | — | $21.00 |
| 2025 (Q1-Q4) | $5.5K | 16 | 169 | $342.98 | $32.47 |
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
$5.6K
Medicare paid
$4.3K
Submitted services
26,300
Denial rate
41.4%
Allowed / service
$0.36
Submitted charges
$76.6K
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 J2247
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
NDC products by labeler
🗃️ 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)
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
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.
❓ J2247 billing FAQ
What is HCPCS code J2247?
J2247 is a HCPCS Level II J-code used to bill Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J2247?
One unit of J2247 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J2247 should I bill?
Divide the dose administered by the code's unit size (1 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 J2247?
The Medicare Part B payment limit is $0.219 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.215 per unit. Payment limits are revised quarterly.
Which NDCs bill under J2247?
2 NDCs currently map to J2247 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 J2247 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.