J7521 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J7521 summary

J7521 is a HCPCS Level II J-code used to bill Tacrolim granules oral susp, 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.

Brand names associated with J7521: Prograf(J7521), Prograf

Code J7521 Billing unit 0.1 MG Payment limit $1.303/unit NDC-Crosswalk 2 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 codeJ7521

DescriptorTacrolim granules oral susp

Billing unit0.1 MG

Payment limit / unit$1.303

Est. ASP / unit$1.229 est.

Mapped NDCs2

Data periodQ3 2026

Last updated2026-08-20

💊 About Tacrolimus DRUG GUIDE

Tacrolimus is prescribed to help prevent your body from rejecting a transplanted organ.

It is used in adults who receive a kidney, liver, or heart transplant, and in children who receive a liver transplant.

It is always used alongside other anti-rejection medicines.Because tacrolimus works by dampening your immune system, it lowers the risk of your body attacking the new organ — but it also means you need to be watched closely for infections and other side effects throughout your treatment.

Read the full Tacrolimus drug guide →

Clinical overview from our editorial drug guide for Tacrolimus. 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

$1.303

Est. ASP / unit

$1.229 est.

Est. after 2% sequester

$1.277

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.

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J7521 = 0.1 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

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 J7521 LEAST EXPENSIVE FIRST

2 NDCs map to J7521. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.303/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00469-1230-50	Prograf Tacrolimus .2 mg/1 GRANULE, FOR SUSPENSION	Astellas	50 PACKET in 1 CARTON (0469-1230-50) / 1...	.2 mg/1	100	$130.30	$5.004	● Active	CMS + PDAC
00469-1330-50	Prograf Tacrolimus 1 mg/1 GRANULE, FOR SUSPENSION	Astellas	50 PACKET in 1 CARTON (0469-1330-50) / 1...	1 mg/1	500	$651.50	$7.445	● Active	CMS + 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.

⚠️ Don't confuse J7521 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J7521. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J7521
J7503	Tacrol envarsus ex rel oral	0.25 MG	$1.863	Different billing unit — 0.25 MG vs 0.1 MG
J7507	Tacrolimus imme rel oral 1mg	1 MG	$0.200	Different billing unit — 1 MG vs 0.1 MG
J7508	Tacrol astagraf ex rel oral	0.1 MG	$0.601	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7525	Tacrolimus injection	5 MG	$268.176	Different billing unit — 5 MG vs 0.1 MG

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$53.4K

Claims

182

Beneficiaries

96

Spend / beneficiary

$555.97

Spend / claim

$293.26

Trend by period

Where J7521 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #605 of 824

#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 #607 CLADRIBINE J9065 $50.6K #608 ZALTRAP J9400 $47.2K #609 DERMACYTE AC MATRX P... Q4343 $45.6K #610 FERRLECIT* J2916 $42.1K

Total claims — #560 of 824

#555 TRI MEMBRANE WRAP, P... Q4344 188 #556 POLOCAINE-MPF* J0670 185 #557 ADRENALIN(J0169) J0169 184 #558 INVEGA HAFYERA* J2427 184 #559 SUBLOCADE(Q9991) Q9991 183 #560 PROGRAF(J7521) J7521 182 #561 HYDRALAZINE HCL J0360 180 #562 AMNICORE PRO+, PER S... Q4299 176 #563 PHENTOLAMINE MESYLAT... J2760 175 #564 CROMOLYN SODIUM J7631 175 #565 BESPONSA J9229 175

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$53.4K	96	182	$555.97	$293.26
2025 (Q1-Q4)	$227.3K	132	626	$1,721.82	$363.07

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

$231.3K

Medicare paid

$181.1K

Submitted services

207,922

Denial rate

8.1%

Allowed / service

$1.21

Submitted charges

$769.4K

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.

📊 What bills under J7521

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

Tacrolimus 2

NDC products by labeler

Astellas Pharma US, Inc. 2

🔗 Related NDC directory pages

🧪 All Tacrolimus NDCsIngredient 🏭 All Astellas labeler NDCsLabeler 00469 📚 All Calcineurin Inhibitor Immunosuppressant NDCsDrug class

🗃️ 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

Not available in current dataset

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)

2 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.

❓ J7521 billing FAQ

What is HCPCS code J7521?

J7521 is a HCPCS Level II J-code used to bill Tacrolim granules oral susp under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J7521?

One unit of J7521 represents 0.1 MG. Report the number of units equal to the dose administered divided by 0.1 MG.

How many units of J7521 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 J7521?

The Medicare Part B payment limit is $1.303 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.277 per unit. Payment limits are revised quarterly.

Which NDCs bill under J7521?

2 NDCs currently map to J7521 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 J7521 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.

J7521 – Tacrolim granules oral susp · NDC Crosswalk & Billing Units