J2357
J2357 – Injection, omalizumab, 5 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 11 NDCs crosswalked per 5 MG $46.588/unit ASP+6%
📋 J2357 summary
J2357 is a HCPCS Level II J-code used to bill omalizumab, 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 J2357: Xolair, Xolair Pfs
Code J2357
Billing unit 5 MG Payment limit $46.588/unit NDC-Crosswalk 11
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 codeJ2357
DescriptorInjection, omalizumab, 5 mg
Billing unit5 MG
Payment limit / unit$46.588
Est. ASP / unit$43.951 est.
Mapped NDCs11
Data periodQ3 2026
Last updated2026-08-20
💊 About Omalizumab Injection DRUG GUIDE
Xolair is used for several allergy-driven conditions.
It treats moderate to severe persistent asthma in adults and children 6 and older whose symptoms aren't controlled by inhaled steroids alone and who test positive for a year-round airborne allergen.
It is also used as an add-on maintenance treatment for chronic rhinosinusitis with nasal polyps (ongoing sinus inflammation with polyp growths) in adults 18 and older who haven't responded well to nasal corticosteroids.Xolair is also approved to reduce allergic reactions — including anaphylaxis — from accidental food exposure in adults and children aged 1 and older with IgE-mediated food allergy.
It must be used alongside strict food avoidance, and it is not a substitute for emergency treatment like epinephrine.
Clinical overview from our editorial drug guide for Omalizumab Injection. 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
$46.588
Est. ASP / unit
$43.951 est.
Est. after 2% sequester
$45.656
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, omalizumab, 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 codeN — No maintenance this year
Effective date2005-01-01
Date added2005-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J2357 = 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 J2357 WITH EST. MEDICARE PAY
11 NDCs map to J2357. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($46.588/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 50242-0040-62 | XOLAIR omalizumab 150 mg/1.2mL INJECTION, SOLUTION | Genentech, | 1 VIAL, SINGLE-USE in 1 CARTON (50242-040-... | 150 mg/1.2mL | 30 | $1,397.64 | — | ● Active | CMS + PDAC |
| 50242-0214-01 | Xolair PFS omalizumab 75 mg/.5mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-214-01... | 75 mg/.5mL | 15 | $698.82 | — | Obsolete | CMS + PDAC |
| 50242-0214-03 | Xolair PFS omalizumab 75 mg/.5mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-214-03... | 75 mg/.5mL | 15 | $698.82 | — | ● Active | CMS + PDAC |
| 50242-0214-55 | Xolair PFS omalizumab 75 mg/.5mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-214-55... | 75 mg/.5mL | 15 | $698.82 | — | ● Active | CMS + PDAC |
| 50242-0215-01 | Xolair PFS omalizumab 150 mg/mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-215-01... | 150 mg/mL | 30 | $1,397.64 | — | Obsolete | CMS + PDAC |
| 50242-0215-03 | Xolair PFS omalizumab 150 mg/mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-215-03... | 150 mg/mL | 30 | $1,397.64 | — | ● Active | CMS + PDAC |
| 50242-0215-55 | Xolair PFS omalizumab 150 mg/mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-215-55... | 150 mg/mL | 30 | $1,397.64 | — | ● Active | CMS + PDAC |
| 50242-0227-01 | Xolair omalizumab 300 mg/2mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-227-01... | 300 mg/2mL | 60 | $2,795.28 | — | ● Active | CMS + PDAC |
| 50242-0227-55 | Xolair omalizumab 300 mg/2mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-227-55... | 300 mg/2mL | 60 | $2,795.28 | — | ● Active | CMS + PDAC |
| 50242-0215-86 | Xolair PFS omalizumab 150 mg/mL INJECTION, SOLUTION | Genentech, | 1 SYRINGE, GLASS in 1 CARTON (50242-215-86... | 150 mg/mL | 30 | $1,397.64 | — | Obsolete | PDAC |
| 50242-0040-86 | XOLAIR omalizumab 150 mg/1.2mL INJECTION, SOLUTION | Genentech, | 1 VIAL, SINGLE-USE in 1 CARTON (50242-040-... | 150 mg/1.2mL | 30 | $1,397.64 | — | ● 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.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$108.12M
Claims
40,450
Beneficiaries
13,732
Spend / beneficiary
$7,873.85
Spend / claim
$2,673.02
Trend by period
Where J2357 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #31 of 824
#26
OPDUALAG J9298
$122.87M
#27
VYVGART HYTRULO J9334
$122.37M
#28
RITUXAN J9312
$119.68M
#29
SYFOVRE J2781
$109.57M
#30
LIBTAYO J9119
$108.14M
#31
XOLAIR J2357
$108.12M
#32
NPLATE J2802
$106.7M
#33
IZERVAY J2782
$105.23M
#34
ILUMYA J3245
$103.49M
#35
VYVGART J9332
$103.34M
#36
OCTREOTIDE ACETATE E... J2353
$101.31M
Total claims — #61 of 824
#56
CINVANTI J0185
42,275
#57
PALONOSETRON HCL J2469
41,742
#58
SYFOVRE J2781
41,654
#59
IZERVAY J2782
41,264
#60
GAMMAKED* J1561
40,877
#61
XOLAIR J2357
40,450
#62
SODIUM CHLORIDE(J704... J7040
40,325
#63
LEQVIO J1306
38,806
#64
ARFORMOTEROL TARTRAT... J7605
38,654
#65
SIMPONI ARIA J1602
38,495
#66
IHEEZO J2403
37,882
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) | $108.12M | 13,732 | 40,450 | $7,873.85 | $2,673.02 |
| 2025 (Q1-Q4) | $434.24M | 17,712 | 182,723 | $24,516.49 | $2,376.47 |
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
$293.71M
Medicare paid
$227.09M
Submitted services
7,601,527
Denial rate
4.1%
Allowed / service
$40.27
Submitted charges
$655.41M
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 J2357 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 3,851,801 services across 42 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 J2357
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)
11 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.
❓ J2357 billing FAQ
What is HCPCS code J2357?
J2357 is a HCPCS Level II J-code used to bill Injection, omalizumab, 5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J2357?
One unit of J2357 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.
How many units of J2357 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 J2357?
The Medicare Part B payment limit is $46.588 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $45.656 per unit. Payment limits are revised quarterly.
Which NDCs bill under J2357?
11 NDCs currently map to J2357 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 J2357 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.