J3095
J3095 – Injection, telavancin, 10 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 3 NDCs crosswalked per 10 MG $7.484/unit ASP+6%
📋 J3095 summary
J3095 is a HCPCS Level II J-code used to bill telavancin, 10 mg, billed per 10 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 J3095: Vibativ
Code J3095
Billing unit 10 MG Payment limit $7.484/unit NDC-Crosswalk 3
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 codeJ3095
DescriptorInjection, telavancin, 10 mg
Billing unit10 MG
Payment limit / unit$7.484
Est. ASP / unit$7.060 est.
Mapped NDCs3
Data periodQ3 2026
Last updated2026-08-20
💊 About Telavancin Injection DRUG GUIDE
Vibativ (telavancin) injection is used to treat two types of serious bacterial infections in adults.
The first is complicated skin and skin structure infections (cSSSI) — deep or serious skin infections caused by certain gram-positive bacteria, including both methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MRSA), as well as some Streptococcus and Enterococcus species.Vibativ is also approved for hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) caused by susceptible Staphylococcus aureus.
For pneumonia, Vibativ should only be used when other treatments are not suitable.
It is not meant for infections that are not caused by bacteria, and it should only be used when an infection is confirmed or strongly suspected to be bacterial.
Clinical overview from our editorial drug guide for Telavancin 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
$7.484
Est. ASP / unit
$7.060 est.
Est. after 2% sequester
$7.334
HCPCS dosage
10 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, telavancin, 10 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 date2011-01-01
Date added2011-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J3095 = 10 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 J3095 WITH EST. MEDICARE PAY
3 NDCs map to J3095. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($7.484/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 66220-0315-22 | VIBATIV telavancin hydrochloride 15 mg/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Cumberland | 12 VIAL, SINGLE-DOSE in 1 CARTON (66220-31... | 15 mg/mL | 900 | $6,735.60 | — | ● Active | CMS + PDAC |
| 66220-0315-44 | VIBATIV telavancin hydrochloride 15 mg/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Cumberland | 4 VIAL, SINGLE-DOSE in 1 CARTON (66220-315... | 15 mg/mL | 300 | $2,245.20 | — | ● Active | CMS + PDAC |
| 62847-0001-01 | VIBATIV (SDV,PF,LYOPHILIZED) 750 MG | Unknown | — | — | 75 | $561.30 | — | — | 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
$109.2K
Claims
131
Beneficiaries
24
Spend / beneficiary
$4,548.59
Spend / claim
$833.33
Trend by period
Where J3095 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #561 of 824
#556
EMTRICITABINE-TENOFO... J0750
$118.9K
#557
EVOMELA J9246
$116.9K
#558
ZERBAXA J0695
$112.1K
#559
ETOPOPHOS* J9181
$111.1K
#560
TEMODAR J9328
$109.5K
#561
VIBATIV J3095
$109.2K
#562
ACTIVATE MATRIX, PER... Q4301
$109.2K
#563
EDARAVONE* J1301
$108.3K
#564
AMNIPLY, PER SQ CM** Q4249
$104.2K
#565
AMNICORE PRO, PER SQ... Q4298
$101.8K
#566
AMINOPHYLLINE J0280
$101.2K
Total claims — #601 of 824
#596
XERAVA J0122
136
#597
ZERBAXA J0695
136
#598
KIMYRSA J2406
133
#599
ACETAMINOPHEN(J0136) J0136
132
#600
METRO IV* J1836
132
#601
VIBATIV J3095
131
#602
ARTACENT WOUND, PER... Q4169
131
#603
LEVOTHYROXINE SODIUM... J0651
128
#604
TEVIMBRA J9329
128
#605
ONDANSETRON HCL(Q016... Q0162
127
#606
AMNIO QUAD-CORE, PER... Q4294
126
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) | $109.2K | 24 | 131 | $4,548.59 | $833.33 |
| 2025 (Q1-Q4) | $993.5K | 123 | 1,010 | $8,077.59 | $983.71 |
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
$905.8K
Medicare paid
$683.1K
Submitted services
153,905
Denial rate
18.6%
Allowed / service
$7.23
Submitted charges
$3.23M
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 J3095 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 56,325 services across 1 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 J3095
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)
3 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.
❓ J3095 billing FAQ
What is HCPCS code J3095?
J3095 is a HCPCS Level II J-code used to bill Injection, telavancin, 10 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J3095?
One unit of J3095 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of J3095 should I bill?
Divide the dose administered by the code's unit size (10 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 J3095?
The Medicare Part B payment limit is $7.484 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $7.334 per unit. Payment limits are revised quarterly.
Which NDCs bill under J3095?
3 NDCs currently map to J3095 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 J3095 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.