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J2679

J2679 – Injection, fluphenazine hcl, 1.25 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 1.25 MG $7.268/unit ASP+6%

This page is curated, coded, and maintained by

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

📋 J2679 summary

J2679 is a HCPCS Level II J-code used to bill fluphenazine hcl, 1.25 mg, billed per 1.25 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 J2679: Fluphenazine Hydrochloride

Code J2679 Billing unit 1.25 MG Payment limit $7.268/unit NDC-Crosswalk 1 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 codeJ2679
DescriptorInjection, fluphenazine hcl, 1.25 mg
Billing unit1.25 MG
Payment limit / unit$7.268
Est. ASP / unit$6.857 est.
Mapped NDCs1
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
$7.268
Est. ASP / unit
$6.857 est.
Est. after 2% sequester
$7.123
HCPCS dosage
1.25 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, fluphenazine hcl, 1.25 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeA — Added this year
Effective date2024-01-01
Date added2024-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J2679 = 1.25 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 J2679 WITH EST. MEDICARE PAY

1 NDC map to J2679. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($7.268/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
63323-0281-10 Fluphenazine Hydrochloride 2.5 mg/mL INJECTION, SOLUTION Fresenius 1 VIAL in 1 BOX (63323-281-10) / 10 mL in... 2.5 mg/mL 20 $145.36 — ● 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.

📊 Medicare utilization & spend CMS · PART B · 2025 (Q1-Q4)

Total Part B spend
$2.9K
Claims
50
Beneficiaries
39
Spend / beneficiary
$73.31
Spend / claim
$57.18
Where J2679 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #856 of 918
#851 RUCONEST J0596 $3.6K #852 CIPROFLOXACIN-D5W J0744 $3.6K #853 VANCOMYCIN HCL(J3374... J3374 $3.5K #854 HYDROXYZINE HCL J3410 $3.2K #855 NITROGLYCERIN IN D5W... J2305 $3.2K #856 FLUPHENAZINE HCL J2679 $2.9K #857 DAUNORUBICIN HCL J9150 $2.7K #858 CANCIDAS* J0637 $2.6K #859 PROTAMINE SULFATE J2720 $2.5K #860 RHOPHYLAC J2791 $2.4K #861 LINEZOLID-D5W* J2020 $2.2K
Total claims — #848 of 918
#843 IXINITY J7213 52 #844 ZEVTERA J0681 51 #845 CLINDAMYCIN-0.9% NAC... J0737 51 #846 CROFAB J0840 51 #847 ARTACENT VERICLEN, P... Q4339 51 #848 FLUPHENAZINE HCL J2679 50 #849 ARRANON* J9261 49 #850 EPINEPHRINE J0166 48 #851 ERAXIS J0348 48 #852 DROPERIDOL J1790 48 #853 SINUVA J7402 48

Full breakdown by period (1)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2025 (Q1-Q4) $2.9K 39 50 $73.31 $57.18
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
—
Medicare paid
$0.00
Submitted services
—
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.

🗃️ 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
1 NDC 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 2025
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.

❓ J2679 billing FAQ

What is HCPCS code J2679?
J2679 is a HCPCS Level II J-code used to bill Injection, fluphenazine hcl, 1.25 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J2679?
One unit of J2679 represents 1.25 MG. Report the number of units equal to the dose administered divided by 1.25 MG.
How many units of J2679 should I bill?
Divide the dose administered by the code's unit size (1.25 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 J2679?
The Medicare Part B payment limit is $7.268 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $7.123 per unit. Payment limits are revised quarterly.
Which NDCs bill under J2679?
1 NDC currently map to J2679 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 J2679 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.