J7527
J7527 – Everolimus, oral, 0.25 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 75 NDCs crosswalked per 0.25 MG $1.163/unit ASP+6%
📋 J7527 summary
J7527 is a HCPCS Level II J-code used to bill Everolimus, oral, 0.25 mg, billed per 0.25 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 J7527: Everolimus, Zortress, Torpenz
Code J7527
Billing unit 0.25 MG Payment limit $1.163/unit NDC-Crosswalk 75
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 codeJ7527
DescriptorEverolimus, oral, 0.25 mg
Billing unit0.25 MG
Payment limit / unit$1.163
Est. ASP / unit$1.097 est.
Mapped NDCs75
Data periodQ3 2026
Last updated2026-08-20
💊 About Everolimus DRUG GUIDE
Everolimus is used to treat several serious conditions.
In cancer, it is prescribed for advanced hormone receptor-positive, HER2-negative breast cancer (in postmenopausal women), certain neuroendocrine tumors of the pancreas, GI tract, or lung, and advanced renal cell carcinoma (kidney cancer) when other treatments have stopped working.It is also used for people with tuberous sclerosis complex (TSC) — a genetic condition that causes benign tumors to grow throughout the body.
In TSC, it treats kidney tumors called angiomyolipomas, brain tumors called SEGA, and seizures.
In kidney transplant patients, it helps prevent the body from rejecting the new organ.
Clinical overview from our editorial drug guide for Everolimus. 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
$1.163
Est. ASP / unit
$1.097 est.
Est. after 2% sequester
$1.140
HCPCS dosage
0.25 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 descriptionEverolimus, oral, 0.25 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1G
ASC payment group—
Action codeN — No maintenance this year
Effective date2014-01-01
Date added2013-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7527 = 0.25 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 J7527 LEAST EXPENSIVE FIRST
75 NDCs map to J7527. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.163/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00054-0470-21 | Everolimus .25 mg/1 TABLET | Hikma | 60 TABLET in 1 BOTTLE (0054-0470-21) | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 49884-0158-02 | Everolimus .25 mg/1 TABLET | Par | 6 BLISTER PACK in 1 CARTON (49884-158-02)... | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 51991-0379-06 | Everolimus .25 mg/1 TABLET | Breckenridge | 60 TABLET in 1 BOTTLE (51991-379-06) | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 51991-0379-60 | Everolimus .25 mg/1 TABLET | Breckenridge | 60 BLISTER PACK in 1 CARTON (51991-379-60)... | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 67877-0718-31 | Everolimus .25 mg/1 TABLET | Ascend | 6 BLISTER PACK in 1 CARTON (67877-718-31)... | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 70377-0069-11 | Everolimus .25 mg/1 TABLET | Biocon | 60 TABLET in 1 BOTTLE (70377-069-11) | .25 mg/1 | 60 | $69.78 | $1.976 | ● Active | CMS + PDAC |
| 00054-0471-21 | Everolimus .5 mg/1 TABLET | Hikma | 60 TABLET in 1 BOTTLE (0054-0471-21) | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 49884-0159-02 | Everolimus .5 mg/1 TABLET | Par | 6 BLISTER PACK in 1 CARTON (49884-159-02)... | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 51991-0380-06 | Everolimus .5 mg/1 TABLET | Breckenridge | 60 TABLET in 1 BOTTLE (51991-380-06) | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 51991-0380-60 | Everolimus .5 mg/1 TABLET | Breckenridge | 60 BLISTER PACK in 1 CARTON (51991-380-60)... | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 67877-0719-31 | Everolimus .5 mg/1 TABLET | Ascend | 6 BLISTER PACK in 1 CARTON (67877-719-31)... | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 70377-0070-11 | Everolimus .5 mg/1 TABLET | Biocon | 60 TABLET in 1 BOTTLE (70377-070-11) | .5 mg/1 | 120 | $139.56 | $3.756 | ● Active | CMS + PDAC |
| 00054-0472-21 | Everolimus .75 mg/1 TABLET | Hikma | 60 TABLET in 1 BOTTLE (0054-0472-21) | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 49884-0160-02 | Everolimus .75 mg/1 TABLET | Par | 6 BLISTER PACK in 1 CARTON (49884-160-02)... | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 51991-0381-06 | Everolimus .75 mg/1 TABLET | Breckenridge | 60 TABLET in 1 BOTTLE (51991-381-06) | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 51991-0381-60 | Everolimus .75 mg/1 TABLET | Breckenridge | 60 BLISTER PACK in 1 CARTON (51991-381-60)... | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 67877-0720-31 | Everolimus .75 mg/1 TABLET | Ascend | 6 BLISTER PACK in 1 CARTON (67877-720-31)... | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 70377-0071-11 | Everolimus .75 mg/1 TABLET | Biocon | 60 TABLET in 1 BOTTLE (70377-071-11) | .75 mg/1 | 180 | $209.34 | $4.572 | ● Active | CMS + PDAC |
| 49884-0283-02 | Everolimus 1 mg/1 TABLET | Par | 6 BLISTER PACK in 1 CARTON (49884-283-02)... | 1 mg/1 | 240 | $279.12 | $5.421 | ● Active | CMS + PDAC |
| 51991-0985-06 | Everolimus 1 mg/1 TABLET | Breckenridge | 60 TABLET in 1 BOTTLE (51991-985-06) | 1 mg/1 | 240 | $279.12 | $5.421 | ● Active | CMS + PDAC |
| 67877-0721-31 | Everolimus 1 mg/1 TABLET | Ascend | 6 BLISTER PACK in 1 CARTON (67877-721-31)... | 1 mg/1 | 240 | $279.12 | $5.421 | ● Active | CMS + PDAC |
| 70377-0112-11 | Everolimus 1 mg/1 TABLET | Biocon | 60 TABLET in 1 BOTTLE (70377-112-11) | 1 mg/1 | 240 | $279.12 | $5.421 | ● Active | CMS + PDAC |
| 00054-0604-21 | Everolimus 1 mg/1 TABLET | Hikma | 60 TABLET in 1 BOTTLE (0054-0604-21) | 1 mg/1 | 4 | $4.65 | $5.421 | ● Active | PDAC |
| 82293-0031-21 | everolimus 5 mg/1 TABLET | Novugen | 4 BLISTER PACK in 1 CARTON (82293-031-21)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 00245-0823-04 | TORPENZ Everolimus 5 mg/1 TABLET | Upsher-Smith | 28 BLISTER PACK in 1 CARTON (0245-0823-04)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 72603-0255-01 | EVEROLIMUS 5 mg/1 TABLET | NorthStar | 30 TABLET in 1 BOTTLE (72603-255-01) | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 00245-0823-30 | TORPENZ Everolimus 5 mg/1 TABLET | Upsher-Smith | 30 TABLET in 1 BOTTLE (0245-0823-30) | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 70377-0011-23 | EVEROLIMUS 5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-011-23)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 70377-0011-11 | EVEROLIMUS 5 mg/1 TABLET | Biocon | 30 TABLET in 1 BOTTLE (70377-011-11) | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 51991-0822-33 | Everolimus 5 mg/1 TABLET | Breckenridge | 30 TABLET in 1 BOTTLE (51991-822-33) | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 70377-0011-22 | EVEROLIMUS 5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-011-22)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 00054-0481-13 | Everolimus 5 mg/1 TABLET | Hikma | 30 TABLET in 1 BOTTLE (0054-0481-13) | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 51991-0822-28 | Everolimus 5 mg/1 TABLET | Breckenridge | 4 BLISTER PACK in 1 CARTON (51991-822-28)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 00093-7767-24 | Everolimus 5 mg/1 TABLET | Teva | 28 BLISTER PACK in 1 CARTON (0093-7767-24)... | 5 mg/1 | 20 | $23.26 | $14.771 | ● Active | PDAC |
| 49884-0125-91 | Everolimus 5 mg/1 TABLET | Par | 28 BLISTER PACK in 1 CARTON (49884-125-91)... | 5 mg/1 | 20 | $23.26 | $14.771 | Obsolete | PDAC |
| 82293-0033-21 | everolimus 10 mg/1 TABLET | Novugen | 4 BLISTER PACK in 1 CARTON (82293-033-21)... | 10 mg/1 | 40 | $46.52 | $26.324 | ● Active | PDAC |
| 00078-0414-20 | Zortress everolimus .5 mg/1 TABLET | Novartis | 60 BLISTER PACK in 1 BOX (0078-0414-20) /... | .5 mg/1 | 120 | $139.56 | — | ● Active | CMS + PDAC |
| 00078-0415-20 | Zortress everolimus .75 mg/1 TABLET | Novartis | 60 BLISTER PACK in 1 BOX (0078-0415-20) /... | .75 mg/1 | 180 | $209.34 | — | ● Active | CMS + PDAC |
| 00078-0417-20 | Zortress everolimus .25 mg/1 TABLET | Novartis | 60 BLISTER PACK in 1 BOX (0078-0417-20) /... | .25 mg/1 | 60 | $69.78 | — | ● Active | CMS + PDAC |
| 00078-0422-20 | Zortress everolimus 1 mg/1 TABLET | Novartis | 60 BLISTER PACK in 1 BOX (0078-0422-20) /... | 1 mg/1 | 240 | $279.12 | — | ● Active | CMS + PDAC |
| 51991-0985-60 | Everolimus | Breckenridge | — | — | 240 | $279.12 | — | — | CMS ASP |
| 82293-0032-21 | everolimus 7.5 mg/1 TABLET | Novugen | 4 BLISTER PACK in 1 CARTON (82293-032-21)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 82293-0030-21 | everolimus 2.5 mg/1 TABLET | Novugen | 4 BLISTER PACK in 1 CARTON (82293-030-21)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 00245-0822-04 | TORPENZ Everolimus 2.5 mg/1 TABLET | Upsher-Smith | 28 BLISTER PACK in 1 CARTON (0245-0822-04)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 00245-0824-04 | TORPENZ Everolimus 7.5 mg/1 TABLET | Upsher-Smith | 28 BLISTER PACK in 1 CARTON (0245-0824-04)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 72603-0254-01 | EVEROLIMUS 2.5 mg/1 TABLET | NorthStar | 30 TABLET in 1 BOTTLE (72603-254-01) | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 72603-0256-01 | EVEROLIMUS 7.5 mg/1 TABLET | NorthStar | 30 TABLET in 1 BOTTLE (72603-256-01) | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 00245-0824-30 | TORPENZ Everolimus 7.5 mg/1 TABLET | Upsher-Smith | 30 TABLET in 1 BOTTLE (0245-0824-30) | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 00245-0822-30 | TORPENZ Everolimus 2.5 mg/1 TABLET | Upsher-Smith | 30 TABLET in 1 BOTTLE (0245-0822-30) | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 70377-0012-23 | EVEROLIMUS 7.5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-012-23)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 70377-0010-23 | EVEROLIMUS 2.5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-010-23)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 70377-0010-11 | EVEROLIMUS 2.5 mg/1 TABLET | Biocon | 30 TABLET in 1 BOTTLE (70377-010-11) | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 70377-0012-11 | EVEROLIMUS 7.5 mg/1 TABLET | Biocon | 30 TABLET in 1 BOTTLE (70377-012-11) | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 51991-0823-33 | Everolimus 7.5 mg/1 TABLET | Breckenridge | 30 TABLET in 1 BOTTLE (51991-823-33) | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 51991-0821-33 | Everolimus 2.5 mg/1 TABLET | Breckenridge | 30 TABLET in 1 BOTTLE (51991-821-33) | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 70377-0010-22 | EVEROLIMUS 2.5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-010-22)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 70377-0012-22 | EVEROLIMUS 7.5 mg/1 TABLET | Biocon | 4 BLISTER PACK in 1 CARTON (70377-012-22)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 00054-0497-13 | Everolimus 7.5 mg/1 TABLET | Hikma | 30 TABLET in 1 BOTTLE (0054-0497-13) | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 51991-0821-28 | Everolimus 2.5 mg/1 TABLET | Breckenridge | 4 BLISTER PACK in 1 CARTON (51991-821-28)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 51991-0823-28 | Everolimus 7.5 mg/1 TABLET | Breckenridge | 4 BLISTER PACK in 1 CARTON (51991-823-28)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 00054-0480-13 | Everolimus 2.5 mg/1 TABLET | Hikma | 30 TABLET in 1 BOTTLE (0054-0480-13) | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 00093-7766-24 | Everolimus 2.5 mg/1 TABLET | Teva | 28 BLISTER PACK in 1 CARTON (0093-7766-24)... | 2.5 mg/1 | 10 | $11.63 | — | ● Active | PDAC |
| 00093-7768-24 | Everolimus 7.5 mg/1 TABLET | Teva | 28 BLISTER PACK in 1 CARTON (0093-7768-24)... | 7.5 mg/1 | 30 | $34.89 | — | ● Active | PDAC |
| 49884-0119-91 | Everolimus 2.5 mg/1 TABLET | Par | 28 BLISTER PACK in 1 CARTON (49884-119-91)... | 2.5 mg/1 | 10 | $11.63 | — | Obsolete | PDAC |
| 49884-0127-91 | Everolimus 7.5 mg/1 TABLET | Par | 28 BLISTER PACK in 1 CARTON (49884-127-91)... | 7.5 mg/1 | 30 | $34.89 | — | Obsolete | PDAC |
| 00078-0422-61 | ZORTRESS (1X1) 1 MG | Unknown | — | — | 4 | $4.65 | — | — | PDAC |
| 00078-0417-61 | ZORTRESS (1X1) 0.25 MG | Unknown | — | — | 1 | $1.16 | — | — | PDAC |
| 00078-0414-61 | ZORTRESS (1X1) 0.5 MG | Unknown | — | — | 2 | $2.33 | — | — | PDAC |
| 00078-0415-61 | ZORTRESS (1X1) 0.75 MG | Unknown | — | — | 3 | $3.49 | — | — | PDAC |
| 00378-3097-85 | EVEROLIMUS 5 MG | Unknown | — | — | 20 | $23.26 | — | — | PDAC |
| 00378-3098-85 | EVEROLIMUS 7.5 MG | Unknown | — | — | 30 | $34.89 | — | — | PDAC |
| 00378-3096-85 | EVEROLIMUS (4X7) 2.5 MG | Unknown | — | — | 10 | $11.63 | — | — | PDAC |
| 00054-0497-14 | EVEROLIMUS (4X7) 7.5 MG | Unknown | — | — | 30 | $34.89 | — | — | PDAC |
| 00054-0481-14 | EVEROLIMUS (4X7) 5 MG | Unknown | — | — | 20 | $23.26 | — | — | PDAC |
| 00054-0480-14 | EVEROLIMUS (4X7) 2.5 MG | Unknown | — | — | 10 | $11.63 | — | — | 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
$1.54M
Claims
5,068
Beneficiaries
2,086
Spend / beneficiary
$740.63
Spend / claim
$304.84
Trend by period
Where J7527 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #343 of 824
#338
ARFORMOTEROL TARTRAT... J7605
$1.64M
#339
CELLCEPT* J7517
$1.62M
#340
CORTROPHIN J0802
$1.6M
#341
AZACITIDINE* J9025
$1.58M
#342
BETHKIS* J7682
$1.58M
#343
EVEROLIMUS* J7527
$1.54M
#344
TEVIMBRA J9329
$1.52M
#345
TRAZIMERA Q5116
$1.52M
#346
EPOPROSTENOL SODIUM* J1325
$1.5M
#347
LEXISCAN* J2785
$1.48M
#348
ABILIFY MAINTENA J0401
$1.47M
Total claims — #222 of 824
#217
PHESGO J9316
5,254
#218
ATROPINE SULFATE(J04... J0461
5,212
#219
TECVAYLI J9380
5,187
#220
MULTIHANCE A9577
5,179
#221
TRIVISC J7329
5,171
#222
EVEROLIMUS* J7527
5,068
#223
VECTIBIX J9303
5,053
#224
DACOGEN* J0894
4,978
#225
CUVITRU J1555
4,827
#226
TYSABRI J2323
4,821
#227
DOXIL* Q2050
4,593
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) | $1.54M | 2,086 | 5,068 | $740.63 | $304.84 |
| 2025 (Q1-Q4) | $10.86M | 2,664 | 22,660 | $4,075.74 | $479.16 |
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
$11.24M
Medicare paid
$8.62M
Submitted services
6,092,330
Denial rate
3.3%
Allowed / service
$1.91
Submitted charges
$67.91M
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 J7527
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)
75 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.
❓ J7527 billing FAQ
What is HCPCS code J7527?
J7527 is a HCPCS Level II J-code used to bill Everolimus, oral, 0.25 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7527?
One unit of J7527 represents 0.25 MG. Report the number of units equal to the dose administered divided by 0.25 MG.
How many units of J7527 should I bill?
Divide the dose administered by the code's unit size (0.25 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 J7527?
The Medicare Part B payment limit is $1.163 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.140 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7527?
75 NDCs currently map to J7527 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 J7527 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.