J8560
J8560 – Etoposide; oral, 50 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 1 NDC crosswalked per 50 MG $88.055/unit ASP+6%
📋 J8560 summary
J8560 is a HCPCS Level II J-code used to bill Etoposide; oral, 50 mg, billed per 50 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Code J8560
Billing unit 50 MG Payment limit $88.055/unit NDC-Crosswalk 1
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 codeJ8560
DescriptorEtoposide; oral, 50 mg
Billing unit50 MG
Payment limit / unit$88.055
Est. ASP / unit$83.071 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20
💊 About Etoposide DRUG GUIDE
Etoposide injection (available as Avopef, Etopophos, Toposar, and Etoposide) is used to treat refractory testicular tumors — cancers that have already been treated with surgery, radiation, and other chemotherapy — always in combination with other cancer drugs.
It is also used for small cell lung cancer (SCLC) as a first-line treatment, given together with other chemotherapy and, in the case of Avopef, with immunotherapy as well.Etoposide capsules (VePesid and Etoposide capsules) are approved for small cell lung cancer as first-line treatment in combination with other chemotherapy agents.
Capsule forms are not approved for testicular cancer, as the label notes that adequate data on their use in that setting are not available.
Clinical overview from our editorial drug guide for Etoposide. 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
$88.055
Est. ASP / unit
$83.071 est.
Est. after 2% sequester
$86.294
HCPCS dosage
50 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 descriptionEtoposide; oral, 50 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment groupYY
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1995-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J8560 = 50 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 J8560 WITH EST. MEDICARE PAY
1 NDC map to J8560. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($88.055/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00378-3266-94 | Etoposide 50 mg/1 CAPSULE | Mylan | 20 CAPSULE in 1 CARTON (0378-3266-94) | 50 mg/1 | 20 | $1,761.10 | — | ● Active | CMS ASP |
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
$337.5K
Claims
252
Beneficiaries
123
Spend / beneficiary
$2,743.88
Spend / claim
$1,339.28
Trend by period
Where J8560 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #478 of 824
#473
ORBACTIV J2407
$354.4K
#474
SUBLOCADE(Q9992) Q9992
$345.4K
#475
CYCLOPHOSPHAMIDE(J90... J9074
$344K
#476
IODIXANOL(Q9966)* Q9966
$341.3K
#477
YESINTEK Q5100
$340.6K
#478
ETOPOSIDE J8560
$337.5K
#479
CYCLOPHOSPHAMIDE(J90... J9076
$332.9K
#480
CIMERLI Q5128
$331.8K
#481
MOZOBIL* J2562
$328.2K
#482
NEOSTIM TL PER SQ CM... Q4265
$325.7K
#483
COCOON MEMBRANE, PER... Q4264
$322.7K
Total claims — #520 of 824
#515
RAMPART DL MATRIX PE... Q4347
256
#516
ALBUTEROL SULFATE(J7... J7612
254
#517
KEDRAB 90377
253
#518
CIDOFOVIR J0740
253
#519
CYTARABINE J9100
253
#520
ETOPOSIDE J8560
252
#521
CYSTO-CONRAY II* Q9958
249
#522
CORTROPHIN J0802
244
#523
ARISTADA J1944
244
#524
AMNIOEXCEL BIODEXCEL... Q4137
242
#525
AMBISOME* J0289
240
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) | $337.5K | 123 | 252 | $2,743.88 | $1,339.28 |
| 2025 (Q1-Q4) | $1.15M | 344 | 1,063 | $3,342.99 | $1,081.83 |
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
$0.00
Medicare paid
$0.00
Submitted services
42
Denial rate
100.0%
Submitted charges
$12.7K
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 J8560 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
🗃️ 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
1 NDC 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.
❓ J8560 billing FAQ
What is HCPCS code J8560?
J8560 is a HCPCS Level II J-code used to bill Etoposide; oral, 50 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J8560?
One unit of J8560 represents 50 MG. Report the number of units equal to the dose administered divided by 50 MG.
How many units of J8560 should I bill?
Divide the dose administered by the code's unit size (50 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 J8560?
The Medicare Part B payment limit is $88.055 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $86.294 per unit. Payment limits are revised quarterly.
Which NDCs bill under J8560?
1 NDC currently map to J8560 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 J8560 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.