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J2796

J2796 – Injection, romiplostim, 10 micrograms · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 2 NDCs crosswalked

This page is curated, coded, and maintained by

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

📋 J2796 summary

J2796 is a HCPCS Level II J-code used to bill romiplostim, 10 micrograms. 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 J2796: Nplate

Code J2796 NDC-Crosswalk 2 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 codeJ2796
DescriptorInjection, romiplostim, 10 micrograms
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs2
Data periodNot available in current dataset
Last updatedSource date not available

💊 About Romiplostim Injection DRUG GUIDE

Nplate (romiplostim) injection is used to treat immune thrombocytopenia (ITP) — a condition where the immune system destroys platelets, leaving counts too low and raising the risk of serious bleeding.

It is approved for adults and children 1 year and older with ITP who have already tried corticosteroids, immunoglobulins, or spleen removal (splenectomy) without enough improvement.Nplate is also approved to increase survival in adults and children (including newborns) who have been exposed to dangerously high doses of radiation that suppress the bone marrow's ability to make blood cells — a condition called Hematopoietic Syndrome of Acute Radiation Syndrome (HS-ARS).

Nplate is not for low platelets caused by myelodysplastic syndrome (MDS) or any other condition besides ITP, and it should never be used just to bring platelet counts to a normal level.

Read the full Romiplostim Injection drug guide →
Clinical overview from our editorial drug guide for Romiplostim Injection. For billing reference, see the sections above.

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit
—
Est. ASP / unit
—
Est. after 2% sequester
—
HCPCS dosage
—
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).
Full HCPCS code details (official CMS record)
Long descriptionInjection, romiplostim, 10 micrograms
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 date2010-01-01
Date added2010-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J2796 = 1 unit. 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 J2796 CROSSWALKED NDCs

2 NDCs map to J2796. Bill units = how many HCPCS units one package represents.
NDC (11-digit)DrugLabelerPackageStrength Bill units NADAC / unit StatusSource
55513-0221-01 Nplate romiplostim 250 ug/.5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION Amgen, 1 VIAL in 1 CARTON (55513-221-01) / .5 mL... 250 ug/.5mL 25 — ● Active PDAC
55513-0222-01 Nplate romiplostim 500 ug/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION Amgen, 1 VIAL in 1 CARTON (55513-222-01) / 1 mL... 500 ug/mL 50 — ● 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.

🗺️ Where J2796 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 63,213 services across 11 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 J2796

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
romiplostim 4
NDC products by labeler
Amgen, Inc 4

🗃️ 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)
Not available
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
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.

❓ J2796 billing FAQ

What is HCPCS code J2796?
J2796 is a HCPCS Level II J-code used to bill Injection, romiplostim, 10 micrograms under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under J2796?
2 NDCs currently map to J2796 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 J2796 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.