J3243
J3243 – Injection, tigecycline, 1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 10 NDCs crosswalked per 1 MG $0.517/unit ASP+6%
📋 J3243 summary
J3243 is a HCPCS Level II J-code used to bill tigecycline, 1 mg, billed per 1 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 J3243: Tygacil, Tigecycline
Code J3243
Billing unit 1 MG Payment limit $0.517/unit NDC-Crosswalk 10
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 codeJ3243
DescriptorInjection, tigecycline, 1 mg
Billing unit1 MG
Payment limit / unit$0.517
Est. ASP / unit$0.488 est.
Mapped NDCs10
Data periodQ3 2026
Last updated2026-08-20
💊 About Tigecycline Injection DRUG GUIDE
Tygacil (tigecycline for injection) is approved for adults 18 and older to treat three types of serious bacterial infections: complicated skin and skin structure infections, complicated intra-abdominal (stomach and intestinal) infections, and community-acquired bacterial pneumonia (pneumonia caught outside a hospital).It is not approved for diabetic foot infections or for pneumonia caught in a hospital setting, including ventilator-associated pneumonia — clinical trials showed it did not work well enough for those uses and was associated with higher mortality in patients with ventilator-associated pneumonia.
Clinical overview from our editorial drug guide for Tigecycline 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
$0.517
Est. ASP / unit
$0.488 est.
Est. after 2% sequester
$0.507
HCPCS dosage
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, tigecycline, 1 mg
CoverageC — Carrier/MAC judgment
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 date2022-01-01
Date added2007-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J3243 = 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 J3243 WITH EST. MEDICARE PAY
10 NDCs map to J3243. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.517/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00008-4990-20 | Tygacil TIGECYCLINE 50 mg/5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Wyeth | 10 VIAL, SINGLE-DOSE in 1 CARTON (0008-499... | 50 mg/5mL | 500 | $258.50 | — | ● Active | CMS ASP |
| 00008-4994-20 | Tygacil TIGECYCLINE 50 mg/5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Wyeth | 10 VIAL, SINGLE-DOSE in 1 CARTON (0008-499... | 50 mg/5mL | 500 | $258.50 | — | ● Active | CMS ASP |
| 00781-3481-92 | Tigecycline 50 mg/10mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Sandoz | 10 VIAL, SINGLE-DOSE in 1 CARTON (0781-348... | 50 mg/10mL | 500 | $258.50 | — | ● Active | CMS + PDAC |
| 55150-0228-10 | Tigecycline 50 mg/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Eugia | 10 VIAL, SINGLE-DOSE in 1 CARTON (55150-22... | 50 mg/1 | 500 | $258.50 | — | ● Active | CMS + PDAC |
| 60505-6098-01 | Tigecycline 50 mg/5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Apotex | 10 VIAL, SINGLE-USE in 1 CARTON (60505-609... | 50 mg/5mL | 500 | $258.50 | — | ● Active | CMS + PDAC |
| 63323-0960-10 | Tigecycline | FreseniUS | — | — | 500 | $258.50 | — | — | CMS ASP |
| 70121-1647-07 | Tigecycline 50 mg/5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Amneal | 10 VIAL in 1 CARTON (70121-1647-7) / 5 mL... | 50 mg/5mL | 500 | $258.50 | — | ● Active | CMS + PDAC |
| 71288-0019-11 | Tigecycline 50 mg/5mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Meitheal | 10 VIAL, SINGLE-DOSE in 1 CARTON (71288-01... | 50 mg/5mL | 500 | $258.50 | — | ● Active | CMS + PDAC |
| 70594-0035-02 | TIGECYCLINE (PF,LYOPHILIZED) 50 MG | Unknown | — | — | 50 | $25.85 | — | — | PDAC |
| 16729-0364-68 | TIGECYCLINE (PF,LYOPHILIZED) 50 MG | Unknown | — | — | 50 | $25.85 | — | — | 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
$940.10
Claims
28
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$33.58
Trend by period
Where J3243 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #772 of 824
#767
TYZAVAN* J3375
$1.1K
#768
PENICILLIN G POTASSI... J2540
$1.1K
#769
STREPTOMYCIN SULFATE J3000
$1.1K
#770
AMPHOTERICIN B J0285
$1.1K
#771
HAVRIX* 90632
$1K
#772
TIGECYCLINE* J3243
$940.10
#773
METRO IV* J1836
$932.49
#774
BUTORPHANOL TARTRATE J0595
$881.00
#775
PHYTONADIONE* J3430
$874.12
#776
AMPICILLIN SODIUM J0290
$832.24
#777
MICAFUNGIN(J2247) J2247
$819.12
Total claims — #749 of 824
#744
BRIXADI(J0577) J0577
29
#745
HYPERRHO* J2790
29
#746
ZIEXTENZO Q5120
29
#747
HYPERHEP B* 90371
28
#748
SPEVIGO J1747
28
#749
TIGECYCLINE* J3243
28
#750
VFEND IV* J3465
28
#751
VALRUBICIN* J9357
28
#752
PALISADE DM MATRIX P... Q4350
28
#753
RECOMBIVAX HB 90743
27
#754
MORPHINE SULFATE(J22... J2272
27
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) | $940.10 | — | 28 | — | $33.58 |
| 2025 (Q1-Q4) | $15.6K | 31 | 490 | $503.72 | $31.87 |
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
$16.1K
Medicare paid
$12.4K
Submitted services
83,377
Denial rate
54.7%
Allowed / service
$0.43
Submitted charges
$616K
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 J3243 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 33,940 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 J3243
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)
10 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.
❓ J3243 billing FAQ
What is HCPCS code J3243?
J3243 is a HCPCS Level II J-code used to bill Injection, tigecycline, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J3243?
One unit of J3243 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J3243 should I bill?
Divide the dose administered by the code's unit size (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 J3243?
The Medicare Part B payment limit is $0.517 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.507 per unit. Payment limits are revised quarterly.
Which NDCs bill under J3243?
10 NDCs currently map to J3243 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 J3243 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.