J9185
J9185 – Injection, fludarabine phosphate, 50 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 7 NDCs crosswalked per 50 MG $206.299/unit ASP+6%
📋 J9185 summary
J9185 is a HCPCS Level II J-code used to bill fludarabine phosphate, 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.
Brand names associated with J9185: Fludarabine
Code J9185
Billing unit 50 MG Payment limit $206.299/unit NDC-Crosswalk 7
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 codeJ9185
DescriptorInjection, fludarabine phosphate, 50 mg
Billing unit50 MG
Payment limit / unit$206.299
Est. ASP / unit$194.622 est.
Mapped NDCs7
Data periodQ3 2026
Last updated2026-08-20
💊 About Fludarabine Injection DRUG GUIDE
Fludarabine Injection is used to treat adult patients with B-cell chronic lymphocytic leukemia (CLL) — a cancer of the blood and bone marrow — whose disease did not respond to, or got worse during, at least one prior standard chemotherapy regimen containing an alkylating agent.It is not established as effective for CLL patients who have never been treated or whose disease is not yet refractory (not responding to treatment).
Your doctor will determine whether this treatment is appropriate based on your treatment history.
Clinical overview from our editorial drug guide for Fludarabine 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
$206.299
Est. ASP / unit
$194.622 est.
Est. after 2% sequester
$202.173
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 descriptionInjection, fludarabine phosphate, 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 date2023-01-01
Date added1994-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9185 = 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 J9185 WITH EST. MEDICARE PAY
7 NDCs map to J9185. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($206.299/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 24201-0237-01 | Fludarabine Phosphate | Hikma | — | — | 1 | $206.30 | — | — | CMS ASP |
| 25021-0242-02 | Fludarabine Phosphate 25 mg/mL INJECTION, SOLUTION | Sagent | 1 VIAL in 1 CARTON (25021-242-02) / 2 mL... | 25 mg/mL | 1 | $206.30 | — | ● Active | CMS + PDAC |
| 45963-0609-55 | Fludarabine phosphate 50 mg/2mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Actavis | 1 VIAL, GLASS in 1 CARTON (45963-609-55)... | 50 mg/2mL | 1 | $206.30 | — | ● Active | CMS + PDAC |
| 59923-0604-02 | Fludarabine Phosphate 25 mg/mL INJECTION | Areva | 1 VIAL, SINGLE-DOSE in 1 CARTON (59923-604... | 25 mg/mL | 1 | $206.30 | — | ● Active | CMS + PDAC |
| 63323-0192-02 | Fludarabine 25 mg/mL INJECTION, SOLUTION | Fresenius | 1 VIAL in 1 BOX (63323-192-02) / 2 mL in... | 25 mg/mL | 1 | $206.30 | — | ● Active | CMS ASP |
| 16729-0131-30 | FLUDARABINE PHOSPHATE (SDV,PF,LATEX-FREE) 25 MG/1 ML | Unknown | — | — | 0.5 | $103.15 | — | — | PDAC |
| 45963-0621-51 | FLUDARABINE PHOSPHATE (PF,LATEX-FREE) 25 MG/1 ML | Unknown | — | — | 0.5 | $103.15 | — | — | 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
$13.6K
Claims
113
Beneficiaries
37
Spend / beneficiary
$368.06
Spend / claim
$120.51
Trend by period
Where J9185 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #672 of 824
#667
PERSERIS J2798
$15.2K
#668
RUCONEST J0596
$15.2K
#669
ACYCLOVIR SODIUM J0133
$14.7K
#670
PIPERACILLIN-TAZOBAC... J2543
$14.7K
#671
MULTIHANCE MULTIPACK A9578
$13.7K
#672
FLUDARABINE PHOSPHAT... J9185
$13.6K
#673
MICAFUNGIN(J2248)* J2248
$13.4K
#674
CORTROSYN* J0834
$13.2K
#675
IMIPENEM-CILASTATIN... J0743
$13.1K
#676
FOSCARNET SODIUM J1455
$12.6K
#677
SURGRAFT XT PER SQ C... Q4269
$12.3K
Total claims — #618 of 824
#613
REEVA, PER SQ CM** Q4314
118
#614
PROTAMINE SULFATE J2720
116
#615
PREDNISOLONE SODIUM... J7510
116
#616
IFEX* J9208
115
#617
NOVOSEVEN RT J7189
114
#618
FLUDARABINE PHOSPHAT... J9185
113
#619
MARGENZA J9353
112
#620
SIMULECT J0480
109
#621
CEFUROXIME SODIUM J0697
109
#622
HYLENEX J3473
109
#623
COCOON MEMBRANE, PER... Q4264
109
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) | $13.6K | 37 | 113 | $368.06 | $120.51 |
| 2025 (Q1-Q4) | $893.2K | 2,574 | 5,706 | $347.02 | $156.54 |
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
$55K
Medicare paid
$51.3K
Submitted services
618
Submitted charges
$490.6K
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 J9185 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 45 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 J9185
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)
7 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.
❓ J9185 billing FAQ
What is HCPCS code J9185?
J9185 is a HCPCS Level II J-code used to bill Injection, fludarabine phosphate, 50 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9185?
One unit of J9185 represents 50 MG. Report the number of units equal to the dose administered divided by 50 MG.
How many units of J9185 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 J9185?
The Medicare Part B payment limit is $206.299 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $202.173 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9185?
7 NDCs currently map to J9185 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 J9185 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.