J3010
J3010 – Injection, fentanyl citrate, 0.1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 79 NDCs crosswalked per 0.1 MG $1.385/unit ASP+6%
📋 J3010 summary
J3010 is a HCPCS Level II J-code used to bill fentanyl citrate, 0.1 mg, billed per 0.1 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Code J3010
Billing unit 0.1 MG Payment limit $1.385/unit NDC-Crosswalk 79
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 codeJ3010
DescriptorInjection, fentanyl citrate, 0.1 mg
Billing unit0.1 MG
Payment limit / unit$1.385
Est. ASP / unit$1.307 est.
Mapped NDCs79
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
$1.385
Est. ASP / unit
$1.307 est.
Est. after 2% sequester
$1.357
HCPCS dosage
0.1 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, fentanyl citrate, 0.1 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 codeN — No maintenance this year
Effective date2001-01-01
Date added1982-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J3010 = 0.1 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 J3010 LEAST EXPENSIVE FIRST
79 NDCs map to J3010. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.385/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00409-9094-22 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Hospira, | 25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 00641-6027-25 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 25 VIAL in 1 CARTON (0641-6027-25) / 2 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 00641-6028-10 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 10 VIAL in 1 CARTON (0641-6028-10) / 5 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 00641-6030-01 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 50 mL in 1 VIAL (0641-6030-01) | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 63323-0806-02 | Fentanyl Citrate .05 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-80... | .05 mg/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 63323-0806-50 | Fentanyl Citrate .05 mg/mL INJECTION, SOLUTION | Fresenius | 1 VIAL, SINGLE-DOSE in 1 CARTON (63323-806... | .05 mg/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 72572-0170-25 | Fentanyl Citrate 50 ug/mL INJECTION | Civica, | 25 VIAL in 1 CARTON (72572-170-25) / 2 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 72572-0171-10 | Fentanyl Citrate 50 ug/mL INJECTION | Civica, | 10 VIAL in 1 CARTON (72572-171-10) / 5 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 72572-0172-01 | Fentanyl Citrate 50 ug/mL INJECTION | Civica, | 1 VIAL in 1 CARTON (72572-172-01) / 50 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS + PDAC |
| 81565-0205-02 | Fentanyl Citrate 50 ug/mL INJECTION | Phlow | 25 VIAL in 1 CARTON (81565-205-02) / 2 mL... | 50 ug/mL | 25 | $34.63 | $1.727 | ● Active | CMS ASP |
| 00409-9093-11 | FENTANYL CITRATE 50 ug/mL INJECTION, SOLUTION | Hospira, | 10 AMPULE in 1 CELLO PACK (0409-9093-11)... | 50 ug/mL | 10 | $13.85 | — | ● Active | CMS ASP |
| 00409-9094-25 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Hospira, | 25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-... | 50 ug/mL | 63 | $87.26 | — | ● Active | CMS + PDAC |
| 00409-9094-28 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Hospira, | 25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-... | 50 ug/mL | 125 | $173.13 | — | ● Active | CMS + PDAC |
| 00409-9094-31 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Hospira, | 25 VIAL, SINGLE-DOSE in 1 TRAY (0409-9094-... | 50 ug/mL | 250 | $346.25 | — | ● Active | CMS + PDAC |
| 00409-9094-61 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Hospira, | 25 CARTON in 1 TRAY (0409-9094-61) / 1 VI... | 50 ug/mL | 625 | $865.63 | — | ● Active | CMS + PDAC |
| 00641-6028-25 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 25 VIAL in 1 CARTON (0641-6028-25) / 5 mL... | 50 ug/mL | 63 | $87.26 | — | ● Active | CMS + PDAC |
| 00641-6029-01 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 20 mL in 1 VIAL (0641-6029-01) | 50 ug/mL | 10 | $13.85 | — | ● Active | CMS + PDAC |
| 00641-6247-25 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 25 VIAL in 1 CARTON (0641-6247-25) / 1 mL... | 50 ug/mL | 13 | $18.01 | — | ● Active | CMS + PDAC |
| 00641-6248-10 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 10 SYRINGE, GLASS in 1 CARTON (0641-6248-1... | 50 ug/mL | 5 | $6.93 | — | ● Active | CMS + PDAC |
| 00641-6249-10 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 10 SYRINGE, GLASS in 1 CARTON (0641-6249-1... | 50 ug/mL | 3 | $4.16 | — | ● Active | CMS ASP |
| 63323-0806-01 | Fentanyl Citrate .05 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-80... | .05 mg/mL | 13 | $18.01 | — | ● Active | CMS + PDAC |
| 63323-0806-05 | Fentanyl Citrate .05 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-80... | .05 mg/mL | 63 | $87.26 | — | ● Active | CMS + PDAC |
| 63323-0806-20 | Fentanyl Citrate .05 mg/mL INJECTION, SOLUTION | Fresenius | 25 VIAL, SINGLE-DOSE in 1 CARTON (63323-80... | .05 mg/mL | 250 | $346.25 | — | ● Active | CMS + PDAC |
| 63323-0808-11 | Fentanyl Citrate 50 ug/mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE in 1 CARTON (63323-808-11) / 1... | 50 ug/mL | 5 | $6.93 | — | ● Active | CMS + PDAC |
| 63323-0810-20 | Fentanyl Citrate 100 ug/2mL INJECTION, SOLUTION | Fresenius | 20 SYRINGE in 1 CARTON (63323-810-20) / 2... | 100 ug/2mL | 20 | $27.70 | — | ● Active | CMS + PDAC |
| 72572-0171-25 | Fentanyl Citrate | Civica, | — | — | 63 | $87.26 | — | — | CMS + PDAC |
| 70092-0685-50 | FENTANYL CITRATE 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0684-48 | FENTANYL CITRATE 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0619-50 | FENTANYL CITRATE-SODIUM CHLORIDE (PF,SULFITE-FREE) 20 MCG/1 ML-0.9% | Unknown | — | — | 0.2 | $0.28 | — | — | PDAC |
| 70092-0497-47 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0495-50 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0494-49 | FENTANYL (MONOJECT BARREL,PF) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0456-43 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0454-44 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0415-47 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0400-43 | FENTANYL CITRATE-SODIUM CHLORIDE (PF,SULFITE-FREE) 10 MCG/1 ML-0.9% | Unknown | — | — | 0.1 | $0.14 | — | — | PDAC |
| 70092-0274-50 | FENTANYL CITRATE-SODIUM CHLORIDE (PF,SULFITE-FREE) 10 MCG/1 ML-0.9% | Unknown | — | — | 0.1 | $0.14 | — | — | PDAC |
| 70092-0247-46 | FENTANYL CITRATE-SODIUM CHLORIDE (PF,SULFITE-FREE) 10 MCG/1 ML-0.9% | Unknown | — | — | 0.1 | $0.14 | — | — | PDAC |
| 70092-0180-79 | FENTANYL (PCA,PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0097-43 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0098-44 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0099-49 | FENTANYL (MONOJECT SYRINGE,PF) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0100-50 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 70092-0505-79 | FENTANYL (PF,SULFITE-FREE) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 49452-0032-01 | Fentanyl Citrate 1 g/g CRYSTAL | Spectrum | 1 g in 1 JAR (49452-0032-1) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 49452-0032-02 | Fentanyl Citrate 1 g/g CRYSTAL | Spectrum | .1 g in 1 BOTTLE, GLASS (49452-0032-2) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 00641-6025-10 | FENTANYL CITRATE 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 00641-6026-05 | FENTANYL CITRATE (SINGLE DOSE, 20MLX5) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 00641-6024-10 | FENTANYL CITRATE (SINGLE DOSE, 10X2ML) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 51927-1019-00 | FENTANYL CITRATE (U.S.P.) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 51552-0687-01 | FENTANYL CITRATE (1X1GM,USP) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 51552-0687-09 | FENTANYL CITRATE (1X500MG,USP) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 38779-1756-03 | Fentanyl Citrate 1 g/g POWDER | Medisca | 5 g in 1 VIAL, GLASS (38779-1756-3) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 00406-1130-52 | Fentanyl Citrate 1 kg/kg POWDER | SpecGx | .001 kg in 1 BOTTLE (0406-1130-52) | 1 kg/kg | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 38779-1756-00 | Fentanyl Citrate 1 g/g POWDER | Medisca | .5 g in 1 VIAL, GLASS (38779-1756-0) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 38779-1756-06 | Fentanyl Citrate 1 g/g POWDER | Medisca | 1 g in 1 VIAL, GLASS (38779-1756-6) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 38779-1756-09 | Fentanyl Citrate 1 g/g POWDER | Medisca | .1 g in 1 VIAL, GLASS (38779-1756-9) | 1 g/g | 10,000 | $13,850.00 | — | ● Active | PDAC |
| 63323-0817-20 | SIMPLIST FENTANYL CITRATE (SD,PF) 50 MCG/1 ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 63275-5100-04 | FENTANYL CITRATE (USP) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 00641-6029-25 | Fentanyl Citrate 50 ug/mL INJECTION | Hikma | 25 VIAL in 1 CARTON (0641-6029-25) / 20 m... | 50 ug/mL | 0.5 | $0.69 | — | ● Active | PDAC |
| 61553-0730-68 | FENTANYL CITRATE-SODIUM CHLORIDE (10X30ML, PCA VIAL) 25 MCG/ML-0.9% | Unknown | — | — | 0.25 | $0.35 | — | — | PDAC |
| 61553-0792-68 | FENTANYL CITRATE-SODIUM CHLORIDE (10X30ML, PCA VIAL) 20 MCG/ML-0.9% | Unknown | — | — | 200 | $277.00 | — | — | PDAC |
| 61553-0795-68 | FENTANYL CITRATE (10X30ML, PCA VIAL) 50 MCG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 61553-0794-68 | FENTANYL CITRATE-SODIUM CHLORIDE (10X30ML, PCA VIAL) 40 MCG/ML-0.9% | Unknown | — | — | 400 | $554.00 | — | — | PDAC |
| 61553-0793-68 | FENTANYL CITRATE-SODIUM CHLORIDE (10X30ML, PCA VIAL) 30 MCG/ML-0.9% | Unknown | — | — | 300 | $415.50 | — | — | PDAC |
| 61553-0791-68 | FENTANYL CITRATE-SODIUM CHLORIDE (10X30ML, PCA VIAL) 10 MCG/ML-0.9% | Unknown | — | — | 100 | $138.50 | — | — | PDAC |
| 00409-9093-35 | FENTANYL CITRATE (AMP,LATEX-FREE) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 00409-9093-32 | FENTANYL CITRATE (10X2ML,LATEX-FREE) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 00409-1276-32 | FENTANYL CITRATE (LUER LOCK,10X2ML,PF) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 61553-0118-41 | FENTANYL CITRATE (INTRAVIA) 0.05 MG/ML | Unknown | — | — | 0.5 | $0.69 | — | — | PDAC |
| 61553-0107-02 | FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 0.5 MG/100 ML-0.9% | Unknown | — | — | 0.05 | $0.07 | — | — | PDAC |
| 61553-0109-72 | FENTANYL CITRATE/SODIUM CHLORIDE (SRN,12 ML) 0.5 MG/100 ML-0.9% | Unknown | — | — | 0.05 | $0.07 | — | — | PDAC |
| 61553-0111-48 | FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 1 MG/100 ML-0.9% | Unknown | — | — | 0.1 | $0.14 | — | — | PDAC |
| 61553-0113-02 | FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 1 MG/100 ML-0.9% | Unknown | — | — | 0.1 | $0.14 | — | — | PDAC |
| 61553-0116-48 | FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 2 MG/100 ML-0.9% | Unknown | — | — | 0.2 | $0.28 | — | — | PDAC |
| 61553-0602-48 | FENTANYL CITRATE/SODIUM CHLORIDE (INTRAVIA) 0.2 MG/100 ML-0.9% | Unknown | — | — | 0.02 | $0.03 | — | — | PDAC |
| 63275-5100-06 | FENTANYL CITRATE (U.S.P.) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 63275-5100-01 | FENTANYL CITRATE (U.S.P.) | Unknown | — | — | 10,000 | $13,850.00 | — | — | PDAC |
| 63275-5100-02 | FENTANYL CITRATE (U.S.P.) | Unknown | — | — | 10,000 | $13,850.00 | — | — | 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
$57.1K
Claims
11,877
Beneficiaries
10,615
Spend / beneficiary
$5.38
Spend / claim
$4.81
Trend by period
Where J3010 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #601 of 824
#596
PREDNISONE INTENSOL* J7512
$63.9K
#597
BIOVANCE 1 SQUARE CM... Q4154
$62.8K
#598
INTEGRA MATRIX** Q4108
$61.9K
#599
ABIO XPL ABIO XPL HY... Q4355
$61.8K
#600
SODIUM CHLORIDE(J704... J7040
$60.2K
#601
FENTANYL CITRATE J3010
$57.1K
#602
LEVOTHYROXINE SODIUM... J0651
$55.4K
#603
PEMETREXED(J9314) J9314
$54.9K
#604
DILAUDID* J1171
$54.5K
#605
PROGRAF(J7521) J7521
$53.4K
#606
ARSENIC TRIOXIDE* J9017
$53K
Total claims — #155 of 824
#150
FULPHILA Q5108
12,305
#151
FASENRA PEN* J0517
12,132
#152
FASLODEX* J9395
12,034
#153
COSENTYX J3247
12,030
#154
VEGZELMA Q5129
12,004
#155
FENTANYL CITRATE J3010
11,877
#156
TRILURON J7332
11,689
#157
AKYNZEO J1454
11,028
#158
RUXIENCE Q5119
11,016
#159
RAPAMUNE* J7520
10,934
#160
GADOTERIDOL* A9579
10,762
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) | $57.1K | 10,615 | 11,877 | $5.38 | $4.81 |
| 2025 (Q1-Q4) | $219.2K | 38,620 | 52,552 | $5.67 | $4.17 |
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
$214.7K
Medicare paid
$166.3K
Submitted services
1,050,055
Denial rate
78.2%
Allowed / service
$0.94
Submitted charges
$4.05M
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 J3010 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 131,545 services across 45 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 J3010
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)
79 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
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.
❓ J3010 billing FAQ
What is HCPCS code J3010?
J3010 is a HCPCS Level II J-code used to bill Injection, fentanyl citrate, 0.1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J3010?
One unit of J3010 represents 0.1 MG. Report the number of units equal to the dose administered divided by 0.1 MG.
How many units of J3010 should I bill?
Divide the dose administered by the code's unit size (0.1 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 J3010?
The Medicare Part B payment limit is $1.385 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.357 per unit. Payment limits are revised quarterly.
Which NDCs bill under J3010?
79 NDCs currently map to J3010 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 J3010 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.