J9260
J9260 – Methotrexate sodium, 50 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 21 NDCs crosswalked per 50 MG $2.941/unit ASP+6%
📋 J9260 summary
J9260 is a HCPCS Level II J-code used to bill Methotrexate sodium, 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 J9260: Methotrexate, Rasuvo
Code J9260
Billing unit 50 MG Payment limit $2.941/unit NDC-Crosswalk 21
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 codeJ9260
DescriptorMethotrexate sodium, 50 mg
Billing unit50 MG
Payment limit / unit$2.941
Est. ASP / unit$2.775 est.
Mapped NDCs21
Data periodQ3 2026
Last updated2026-08-20
💊 About Methotrexate Injection DRUG GUIDE
Methotrexate for Injection is used to treat several types of cancer, including acute lymphoblastic leukemia, non-Hodgkin lymphoma, osteosarcoma, breast cancer, squamous cell carcinoma of the head and neck, and gestational trophoblastic neoplasia.
It is also used for the prevention and treatment of meningeal leukemia (leukemia that has spread to the fluid around the brain and spinal cord).Beyond cancer, Methotrexate for Injection treats adults with rheumatoid arthritis and severe psoriasis, and pediatric patients with polyarticular juvenile idiopathic arthritis (pJIA).
The injectable form is given by a healthcare professional and the specific route — intravenous, intramuscular, subcutaneous, or intrathecal — depends on the condition being treated.
Clinical overview from our editorial drug guide for Methotrexate 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
$2.941
Est. ASP / unit
$2.775 est.
Est. after 2% sequester
$2.882
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 descriptionMethotrexate sodium, 50 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1984-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9260 = 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 J9260 LEAST EXPENSIVE FIRST
21 NDCs map to J9260. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($2.941/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00703-3675-01 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Teva | 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3675... | 25 mg/mL | 5 | $14.71 | $0.702 | Obsolete | CMS ASP |
| 00143-9519-10 | Methotrexate 25 mg/mL SOLUTION | Hikma | 10 VIAL in 1 CARTON (0143-9519-10) / 2 mL... | 25 mg/mL | 10 | $29.41 | $1.238 | ● Active | CMS + PDAC |
| 00703-3671-01 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Teva | 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3671... | 25 mg/mL | 1 | $2.94 | $1.756 | ● Active | CMS ASP |
| 16729-0277-30 | Methotrexate 25 mg/mL INJECTION | Accord | 1 VIAL in 1 CARTON (16729-277-30) / 2 mL... | 25 mg/mL | 1 | $2.94 | $1.756 | ● Active | CMS ASP |
| 61703-0161-05 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 5 VIAL, MULTI-DOSE in 1 CARTON (61703-161-... | 25 mg/mL | 5 | $14.71 | $3.128 | ● Active | CMS + PDAC |
| 61703-0350-10 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-... | 25 mg/mL | 5 | $14.71 | $3.128 | ● Active | CMS ASP |
| 61703-0350-38 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 5 VIAL, MULTI-DOSE in 1 CARTON (61703-350-... | 25 mg/mL | 5 | $14.71 | $3.128 | ● Active | CMS + PDAC |
| 63323-0123-10 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Fresenius | 1 VIAL in 1 CARTON (63323-123-10) / 10 mL... | 25 mg/mL | 5 | $14.71 | $3.128 | ● Active | CMS + PDAC |
| 59137-0510-04 | Rasuvo methotrexate 10 mg/.2mL INJECTION, SOLUTION | Medexus | 4 PACKAGE in 1 CARTON (59137-510-04) / .2... | 10 mg/.2mL | 1 | $2.94 | $721.814 | ● Active | PDAC |
| 00143-9367-01 | Methotrexate 1 g/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Hikma | 1 VIAL in 1 BOX (0143-9367-01) / 1 INJECT... | 1 g/1 | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 00143-9830-01 | Methotrexate 1 g/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Hikma | 1 VIAL in 1 BOX (0143-9830-01) / 1 INJECT... | 1 g/1 | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 00703-3678-01 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Teva | 1 VIAL, SINGLE-DOSE in 1 CARTON (0703-3678... | 25 mg/mL | 20 | $58.82 | — | Obsolete | CMS ASP |
| 00703-3678-81 | Methotrexate Sodium | Teva | — | — | 20 | $58.82 | — | — | CMS ASP |
| 16729-0277-35 | Methotrexate 25 mg/mL INJECTION | Accord | 1 VIAL in 1 CARTON (16729-277-35) / 40 mL... | 25 mg/mL | 20 | $58.82 | — | ● Active | CMS ASP |
| 61703-0124-40 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-124... | 25 mg/mL | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 61703-0408-25 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-408... | 25 mg/mL | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 61703-0408-41 | Methotrexate 25 mg/mL INJECTION, SOLUTION | Hospira, | 1 VIAL, SINGLE-DOSE in 1 CARTON (61703-408... | 25 mg/mL | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 63323-0122-50 | Methotrexate 1 g/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Fresenius | 1 VIAL in 1 CARTON (63323-122-50) / 1 INJ... | 1 g/1 | 20 | $58.82 | — | ● Active | CMS + PDAC |
| 63323-0121-08 | METHOTREXATE SODIUM (S.D.V.,PF) 25 MG/1 ML | Unknown | — | — | 0.5 | $1.47 | — | — | PDAC |
| 63323-0121-10 | METHOTREXATE SODIUM (S.D.V.,PF) 25 MG/1 ML | Unknown | — | — | 0.5 | $1.47 | — | — | PDAC |
| 63323-0121-40 | METHOTREXATE SODIUM (VIAL,PF) 25 MG/1 ML | Unknown | — | — | 0.5 | $1.47 | — | — | 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
$24.2K
Claims
6,064
Beneficiaries
1,878
Spend / beneficiary
$12.90
Spend / claim
$3.99
Trend by period
Where J9260 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #642 of 824
#637
LINCOCIN* J2010
$27.1K
#638
ARANESP(J0882) J0882
$25.4K
#639
VINCASAR PFS* J9370
$24.6K
#640
HYPERHEP B* 90371
$24.3K
#641
ENOXAPARIN SODIUM* J1650
$24.3K
#642
METHOTREXATE SODIUM* J9260
$24.2K
#643
PROCAINAMIDE HCL J2690
$24.1K
#644
THIAMINE HCL J3411
$23.6K
#645
XERAVA J0122
$22.8K
#646
VINBLASTINE SULFATE J9360
$22.8K
#647
PROVOCHOLINE J7674
$22.4K
Total claims — #207 of 824
#202
TRODELVY J9317
6,486
#203
AZASAN* J7500
6,362
#204
HEPARIN SODIUM IN 0.... J1644
6,338
#205
NOVAVAX COVID (EUA... 91304
6,132
#206
YERVOY J9228
6,126
#207
METHOTREXATE SODIUM* J9260
6,064
#208
CISPLATIN J9060
5,947
#209
VYVGART J9332
5,872
#210
FUROSEMIDE(J1938) J1938
5,781
#211
HYDROCORTISONE SOD S... J1720
5,777
#212
DESCOVY J0751
5,521
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) | $24.2K | 1,878 | 6,064 | $12.90 | $3.99 |
| 2025 (Q1-Q4) | $111.6K | 4,602 | 29,347 | $24.25 | $3.80 |
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
$110.5K
Medicare paid
$84.9K
Submitted services
48,121
Denial rate
4.8%
Allowed / service
$2.41
Submitted charges
$726.3K
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 J9260 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 25,242 services across 23 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 J9260
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)
21 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.
❓ J9260 billing FAQ
What is HCPCS code J9260?
J9260 is a HCPCS Level II J-code used to bill Methotrexate sodium, 50 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9260?
One unit of J9260 represents 50 MG. Report the number of units equal to the dose administered divided by 50 MG.
How many units of J9260 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 J9260?
The Medicare Part B payment limit is $2.941 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $2.882 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9260?
21 NDCs currently map to J9260 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 J9260 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.