Q4 2026Public CMS & FDA data, traced to the source file
Find the code. Count the units. Trace every number.
Drug coding and reimbursement intelligence, simplified. HCPCS codes, NDC billing units, CMS crosswalks, and Medicare Part B payment limits for clinician-administered drugs.
- HCPCS Level II codes
- 8,770
- 2,060 drug-related
- Drugs indexed
- 2,429
- from the FDA NDC Directory
- NDC packages
- 16,087
- listed and CMS-crosswalked
- Part B payment limits
- 886
- effective Q4 2026
Tools for the infusion workflow
From the chair to the chargemaster: units and claim lines, then audits, margins, biosimilars, and what changed this quarter.
Billing-unit calculator
Pharmacists and billersDose to HCPCS units with the formula shown, plus the CMS MUE check, JW/JZ claim lines with the NDC segment, a vial optimizer with dose-rounding options, and a printable worksheet.Vial barcode scanner
Pharmacists and techniciansScan the 2D barcode on a vial or carton with your phone camera, a photo, or a USB scanner: NDC, HCPCS code, billable units, container type, Medicaid unit type, lot, and expiry — straight into the calculator.Chargemaster & formulary audit
Revenue integrity and pharmacy directorsPaste or upload HCPCS codes and NDCs (or code–NDC pairs) and see terminated codes, NDCs missing from the CMS crosswalk, mismatched pairs, FDA listing problems, payment limits, and MUEs. Export to CSV.Margin analyzer
Directors and financeCompare your own acquisition cost with the Medicare Part B payment (ASP-based limit, net of sequestration) per billing unit and per package, and find drugs that are underwater. Your costs never leave your browser.Site of care: HOPD vs home
Infusion and pharmacy directorsMonthly revenue for one therapy in your hospital outpatient department versus your home infusion pharmacy (no Medicare HIT certification), for Medicare, Washington Apple Health, and your commercial contracts — from CMS OPPS rates, the HCA schedule, and terms you enter.Part B vs Part D
Pharmacists, billers, and intakeWhich Medicare benefit pays for a drug in each setting, with the CMS source for every answer: Noridian's self-administered drug list, DME policies, Washington Part D plan coverage, and the dollars for each lawful pathway.MultiCare price benchmark
Contracting and financeWhat MultiCare's Washington hospitals have negotiated for a drug, per CMS billing unit and as a percent of the Medicare payment limit, by plan type — from their federally required price transparency files. No payer names.Biosimilar comparator
Formulary and P&T committeesReference biologics side by side with their FDA-licensed biosimilars, plus a switch simulator: annual Medicare payment, patient coinsurance, and margin when part of the volume moves to a biosimilar.What changed this quarter
Everyone who maintains a chargemasterPayment-limit movers, new and terminated drug codes, codes added to or dropped from the payment file, and NDCs added to or removed from the CMS crosswalk — with a personal watchlist and an RSS feed.Referral intake card
Intake and prior-authorization staffOne printable page per drug code: billing unit, MUEs, NDCs with claim unit qualifiers, the Medicare hospital and home payment path, Washington Apple Health prior authorization, and related biologics. No patient fields.
How CodeRx works
Search anything
Brand or generic name, any HCPCS code, an NDC in any format, or a manufacturer. Suggestions are grouped and explain why they matched.
Read the coding
See the descriptor, billing unit, code family, effective and termination dates, NDC packages with billable units, and Medicare payment limits.
Verify the source
Every section names the CMS or FDA file it came from, its effective period, when it was published and imported, and links to the original.
Built for people who submit the claim
Pharmacists, infusion centers, coders, revenue-cycle and prior-authorization teams — anyone who needs the code, the unit, and the evidence.
Official NDC ↔ HCPCS links only
Package-to-code relationships come from CMS crosswalk rows — never inferred from similar names or ingredients.
Quarterly history since 2021
Quarterly Part B payment limits, CMS revisions to posted quarters, and HCPCS code changes and terminations.
Biosimilars and references
Biosimilar and interchangeable products linked to their reference biologic through FDA Purple Book license numbers.
Tools that show their work
A unit calculator with the CMS MUE check, JW/JZ claim lines, and a vial optimizer — plus a chargemaster audit, margin analyzer, biosimilar comparator, and quarterly change report.
Every code family
J, Q, C, A, P, and S codes with billing context — including non-Medicare S-codes and the CMS NOC code list.
Honest about gaps
When no authoritative public data exists for a field, CodeRx says so instead of filling it in.
New drug codes Q4 2026
Drug-related codes added in the latest CMS HCPCS quarterly file.
- C9311Injection, eplontersen, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)Added Oct 1, 2026
- C9312Injection, trabectedin (apotex), not therapeutically equivalent to j9362, 0.01 mgAdded Oct 1, 2026
- C9313Injection, pivekimab sunirine-pvzy, 0.01 mgAdded Oct 1, 2026
- J0014Cocaine hydrochloride nasal solution (goprelto), 1 mgAdded Oct 1, 2026
- J0643Injection, leucovorin calcium, not otherwise specified, 1 mgAdded Oct 1, 2026
- J0644Injection, leucovorin calcium (avyxa), 1 mgAdded Oct 1, 2026
- J0871Injection, daptomycin (endo), not therapeutically equivalent to j0878, 1 mgAdded Oct 1, 2026
- J1757Injection, tividenofusp alfa-eknm, 1 mgAdded Oct 1, 2026
- J1818Injection, pegzilarginase-nbln, 0.05 mgAdded Oct 1, 2026
- J1946Injection, furosemide (lasix onyu), 1 mgAdded Oct 1, 2026
- J1947Injection, furosemide (furoscix), 1 mgAdded Oct 1, 2026
- J1957Injection, levetiracetam, 5 mgAdded Oct 1, 2026
Where the data comes from
Government publications only, imported on a schedule that matches each publisher. No AWP, WAC, or commercial payer rates.
- Official CMSQ4 2026
HCPCS Level II Quarterly Update (Alpha-Numeric HCPCS File)
CMS · published Updated 09/23/2026 · imported Oct 15, 2026 05:52 UTC
- Official CMS2026-11-05
Medicare Coverage Database — Current Article Data (Billing and Coding articles)
CMS · published Last-Modified Thu, 05 Nov 2026 07:00:11 GMT · imported Nov 7, 2026 05:33 UTC
- Official CMS2026-11-05
Medicare Coverage Database — Current LCD Data (DME MAC drug policies)
CMS · published Last-Modified Thu, 05 Nov 2026 07:00:12 GMT · imported Nov 7, 2026 06:04 UTC
- Official CMSQ2 2026
Drug Products in the Medicaid Drug Rebate Program
CMS · published Last-Modified Thu, 13 Aug 2026 20:53:48 GMT · imported Oct 17, 2026 05:12 UTC
- Official CMSQ4 2026
Medicare NCCI Medically Unlikely Edits — DME Supplier Services MUE Table
CMS · published Effective October 1, 2026; Posted September 1, 2026 · imported Oct 16, 2026 05:24 UTC
- Official CMSQ4 2026
Medicare NCCI Medically Unlikely Edits — Facility Outpatient Hospital Services MUE Table
CMS · published Effective October 1, 2026; Posted September 1, 2026 · imported Oct 16, 2026 05:23 UTC
- Official CMSQ4 2026
Medicare NCCI Medically Unlikely Edits — Practitioner Services MUE Table
CMS · published Effective October 1, 2026; Posted September 1, 2026 · imported Oct 16, 2026 05:23 UTC
- Official CMSQ4 2026
NDC–HCPCS Crosswalks (ASP, OPPS, AWP, PrEP, NOC)
CMS · published 09/17/2026 - Final file · imported Oct 15, 2026 05:54 UTC
- Official CMSQ4 2026
Hospital Outpatient Prospective Payment System (OPPS) Addendum A (payment by APC), quarterly update
CMS · published Addendum A - Updated 10/15/2026 · imported Oct 27, 2026 02:58 UTC
- Official CMSQ4 2026
Hospital Outpatient Prospective Payment System (OPPS) Addendum B (payment by HCPCS code), quarterly update
CMS · published Addendum B - Updated 10/15/2026 · imported Oct 27, 2026 02:58 UTC
- Official CMSQ3 2026
Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information (Washington plans)
CMS · published Quarterly file 2026-09-01 · imported Nov 7, 2026 05:36 UTC
- Official CMSQ4 2026
Medicare Part B Drug Payment Limit File (ASP pricing file)
CMS · published 09/17/2026 - Final file · imported Oct 23, 2026 03:44 UTC
- Official FDA2026-11-06
National Drug Code Directory (finished drugs)
FDA · published Last-Modified Fri, 06 Nov 2026 09:15:33 GMT · imported Nov 7, 2026 10:35 UTC
- Official FDA2026-11-06
NDC Directory — excluded products and packages
FDA · published Last-Modified Fri, 06 Nov 2026 09:15:48 GMT · imported Nov 7, 2026 10:35 UTC
- Official FDA2026-11-06
openFDA NDC bulk download (product NDC to RxCUI link)
FDA · published Last-Modified Fri, 06 Nov 2026 20:34:12 GMT · imported Nov 7, 2026 05:34 UTC
- Official FDA2026-09
Purple Book: Database of Licensed Biological Products (monthly data)
FDA · published FDA Purple Book — administrator upload of the official file · imported Oct 15, 2026 06:03 UTC
- Hospital price transparency fileyakima-memorial
Hospital standard charges (45 CFR 180.50) — MultiCare Yakima Memorial Hospital
MultiCare Health System · published File last updated 2026-08-27; CMS template v3.0.0 · imported Oct 31, 2026 13:13 UTC
- Official state Medicaid2026-07-01
Apple Health (Medicaid) Home Infusion Therapy/Parenteral Nutrition Program fee schedule
Washington State HCA · published July 1, 2026 · imported Oct 23, 2026 10:35 UTC
- Official state Medicaid2026-10-01
Apple Health (Medicaid) Professional Administered Drug Fee Schedule
Washington State HCA · published Effective October 1, 2026; Updated October 29, 2026 · imported Oct 31, 2026 12:55 UTC
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Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.