Descriptors and administrative fields exactly as published in the CMS HCPCS quarterly file.
Billing context: J-codes
Not otherwise classified
Units are reported in multiples of the dosage in the code descriptor.
One HCPCS billing unit of J0665
0.5 MG
Medicare payment limit per unit (Q4 2026): $0.010
No published MUE for J0665. CMS keeps some MUE values confidential, so this does not mean there is no daily unit limit.
Medicare Part B drug payment limits per billing unit, by quarter, from the CMS payment limit (ASP) files.
Current Medicare Part B payment limit · Q4 2026
$0.010per 0.5 MG
Effective Oct 1, 2026 – Dec 31, 2026 · ASP methodology (per CMS file) · based on Q2 2026 ASP data · coinsurance 20.000%
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2026 | Oct 1, 2026 – Dec 31, 2026 | $0.010 | 0.5 MG | 20% | −9.1% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.011 | 0.5 MG | 20% | +10.0% | — |
| Q2 2026 |
Medicare hospital outpatient (OPPS) · Q4 2026
N Packaged: no separate payment
Washington Apple Health · professional claims
AAC = actual acquisition cost, based on NDC or invoice; BR = by report; NC = not covered; DC = not covered, see a different code; DP = covered under another program (see comments); PA = prior authorization; EPA = expedited prior authorization (see the billing guide); CPA = contractor prior authorization (Qualis). For professional claims; hospital-administered drugs are paid under HCA's outpatient (OPPS/EAPG) rules.
Packages CMS assigns to this code in its NDC–HCPCS crosswalks, with billable units per package. Only official crosswalk rows are shown.
| NDC (11-digit) | CMS drug name · labeler | Pkg size × qty | Units / item | Units / NDC | Derived $ / NDC | Crosswalk | Quarters | FDA listing |
|---|---|---|---|---|---|---|---|---|
| 50090-4516-00 | Bupivacaine HClA-S Medication Solutions | 50 × 1 | 500 | 500 | $5.00 | ASP | Q3 2025 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 71351-0022-10 | Bupivacaine HClBrookfield Pharmaceuticals, LLC | 2 × 10 | 30 | 300 | $3.00 | ASP | Q4 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0167-10 | Bupivacaine HClEugia US LLC | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0168-30 | Bupivacaine HClEugia US LLC | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0169-10 | Bupivacaine HClEugia US LLC | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0170-30 | Bupivacaine HClEugia US LLC | 30 × 25 | 300 | 7,500 | $75.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0171-10 | Bupivacaine HClEugia US LLC | 10 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0172-30 | Bupivacaine HClEugia US LLC | 30 × 25 | 450 | 11,250 | $112.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0249-50 | Bupivacaine HClEugia US LLC | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 55150-0250-50 | Bupivacaine HClEugia US LLC | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72266-0263-10 | Bupivacaine HClFosun Pharma Usa Inc. | 10 × 10 | 50 | 500 | $5.00 | ASP | Q3 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72266-0264-10 | Bupivacaine HClFosun Pharma Usa Inc. | 10 × 10 | 100 | 1,000 | $10.00 | ASP | Q3 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 63323-0464-17 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0464-37 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0464-38 | BupivicaineFreseniUS Kabi USA, LLC | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q3 2024 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0464-39 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q1 2025 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0465-57 | SensorcaineFreseniUS Kabi USA, LLC | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine |
| 63323-0466-17 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0466-37 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 30 × 25 | 300 | 7,500 | $75.00 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0466-38 | Sensorcaine MPFFreseniUS Kabi USA, LLC | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q2 2025 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0466-39 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 30 × 25 | 300 | 7,500 | $75.00 | ASP | Q1 2025 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0467-57 | SensorcaineFreseniUS Kabi USA, LLC | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine |
| 63323-0472-17 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 10 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 63323-0472-37 | Sensorcaine-MPFFreseniUS Kabi USA, LLC | 30 × 25 | 450 | 11,250 | $112.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 00404-9768-30 | MarcaineHenry Schein Inc. | 30 × 1 | 300 | 300 | $3.00 | ASP | Q3 2026 – Q4 2026 | ListedMarcaine |
| 00404-9770-10 | MarcaineHenry Schein Inc. | 10 × 1 | 50 | 50 | $0.50 | ASP | Q2 2026 – Q4 2026 | ListedMarcaine |
| 00404-9826-50 | Bupivacaine HClHenry Schein Inc. | 50 × 1 | 250 | 250 | $2.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00404-9827-50 | Bupivacaine HClHenry Schein Inc. | 50 × 1 | 500 | 500 | $5.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00404-9906-10 | MarcaineHenry Schein Inc. | 10 × 1 | 50 | 50 | $0.50 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00404-9907-10 | MarcaineHenry Schein Inc. | 10 × 1 | 100 | 100 | $1.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00404-9907-30 | MarcaineHenry Schein Inc. | 30 × 1 | 300 | 300 | $3.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00404-9945-50 | SensorcaineHenry Schein Inc. | 50 × 1 | 250 | 250 | $2.50 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine |
| 00404-9946-10 | SensorcaineHenry Schein Inc. | 10 × 1 | 100 | 100 | $1.00 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine Mpf |
| 00404-9947-50 | SensorcaineHenry Schein Inc. | 50 × 1 | 500 | 500 | $5.00 | ASP | Q3 2023 – Q4 2026 | ListedSensorcaine |
| 52584-0465-57 | Bupivacaine HClHenry Schein Inc. | 50 × 1 | 250 | 250 | $2.50 | ASP | Q1 2025 – Q4 2026 | Excluded listingSensorcaine |
| 52584-0467-57 | Bupivacaine HClHenry Schein Inc. | 50 × 1 | 500 | 500 | $5.00 | ASP | Q1 2025 – Q4 2026 | Excluded listingSensorcaine |
| 51662-1396-01 | Bupivacaine HClHF Acquisition Co. LLC, DBA HealthFirst | 50 × 1 | 500 | 500 | $5.00 | ASP | Q4 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 51662-1396-03 | Bupivacaine HClHF Acquisition Co. LLC, DBA HealthFirst | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q4 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 51662-1581-03 | Bupivacaine HClHF Acquisition Co. LLC, DBA HealthFirst | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q4 2023 – Q4 2026 | ListedBUPIVACAINE HCI |
| 51662-1588-03 | SensorcaineHF Acquisition Co. LLC, DBA HealthFirst | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q4 2023 – Q4 2026 | ListedBUPIVACAINE HCl |
| 51662-1592-03 | SensorcaineHF Acquisition Co. LLC, DBA HealthFirst | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q1 2024 – Q4 2026 | ListedBUPIVACAINE HCl |
| 00143-9328-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 50 × 10 | 250 | 2,500 | $25.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9329-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 50 × 10 | 500 | 5,000 | $50.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9330-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 10 × 10 | 50 | 500 | $5.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9331-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 10 × 10 | 100 | 1,000 | $10.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9332-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 10 × 10 | 150 | 1,500 | $15.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9333-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 30 × 10 | 150 | 1,500 | $15.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9334-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 30 × 10 | 300 | 3,000 | $30.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00143-9335-10 | Bupivacaine HClHikma Pharmaceuticals USA Inc. | 30 × 10 | 450 | 4,500 | $45.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 71288-0721-11 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 10 × 1 | 50 | 50 | $0.50 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 71288-0722-32 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 30 × 1 | 150 | 150 | $1.50 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 71288-0723-52 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 50 × 1 | 250 | 250 | $2.50 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 71288-0724-11 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 10 × 1 | 100 | 100 | $1.00 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 71288-0725-32 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 30 × 1 | 300 | 300 | $3.00 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 71288-0726-52 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 50 × 1 | 500 | 500 | $5.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 71288-0727-11 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 10 × 1 | 150 | 150 | $1.50 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 71288-0728-32 | Bupivacaine HClMeitheal Pharmaceuticals Inc. | 30 × 1 | 450 | 450 | $4.50 | ASP | Q3 2024 – Q4 2026 | Excluded listingBupivacaine Hydrochloride |
| 72603-0279-25 | Bupivacaine HClNorthstar RxLLC | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0287-25 | Bupivacaine HClNorthstar RxLLC | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0327-25 | Bupivacaine HClNorthstar RxLLC | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0506-10 | Bupivacaine HClNorthstar RxLLC | 10 × 10 | 100 | 1,000 | $10.00 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0506-25 | Bupivacaine HClNorthstar RxLLC | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0700-10 | Bupivacaine HClNorthstar RxLLC | 10 × 10 | 150 | 1,500 | $15.00 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0700-25 | Bupivacaine HClNorthstar RxLLC | 10 × 25 | 150 | 3,750 | $37.50 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 72603-0800-25 | Bupivacaine HClNorthstar RxLLC | 30 × 25 | 450 | 11,250 | $112.50 | ASP | Q1 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-0525-25 | MarcainePfizer Inc | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q3 2025 – Q4 2026 | ListedMarcaine |
| 00409-1159-01 | Bupivacaine HClPfizer Inc | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1159-02 | Bupivacaine HClPfizer Inc | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1159-10 | Bupivacaine HClPfizer Inc | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1160-01 | Bupivacaine HClPfizer Inc | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1162-01 | Bupivacaine HClPfizer Inc | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1162-02 | Bupivacaine HClPfizer Inc | 30 × 25 | 300 | 7,500 | $75.00 | ASP | Q3 2024 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1163-01 | Bupivacaine HClPfizer Inc | 50 × 25 | 500 | 12,500 | $125.00 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1165-01 | Bupivacaine HClPfizer Inc | 10 × 25 | 150 | 3,750 | $37.50 | ASP | Q4 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1165-02 | Bupivacaine HClPfizer Inc | 30 × 25 | 450 | 11,250 | $112.50 | ASP | Q3 2023 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 00409-1530-25 | MarcainePfizer Inc | 30 × 25 | 300 | 7,500 | $75.00 | ASP | Q1 2026 – Q4 2026 | ListedMarcaine |
| 00409-1559-10 | MarcainePfizer Inc | 10 × 10 | 50 | 500 | $5.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1559-30 | MarcainePfizer Inc | 30 × 10 | 150 | 1,500 | $15.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1560-10 | MarcainePfizer Inc | 10 × 10 | 100 | 1,000 | $10.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1560-29 | MarcainePfizer Inc | 30 × 10 | 300 | 3,000 | $30.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1582-10 | MarcainePfizer Inc | 10 × 10 | 150 | 1,500 | $15.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1582-29 | MarcainePfizer Inc | 30 × 10 | 450 | 4,500 | $45.00 | ASP | Q3 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1587-50 | MarcainePfizer Inc | 50 × 1 | 250 | 250 | $2.50 | ASP | Q3 2024 – Q4 2026 | Excluded listingMarcaine |
| 00409-1610-50 | MarcainePfizer Inc | 50 × 1 | 500 | 500 | $5.00 | ASP | Q4 2023 – Q4 2026 | Excluded listingMarcaine |
| 00409-1761-10 | Marcaine SpinalPfizer Inc | 2 × 10 | 30 | 300 | $3.00 | ASP | Q3 2023 – Q4 2026 | ListedMarcaine Spinal |
| 00409-1761-62 | Marcaine SpinalPfizer Inc | 2 × 800 | 30 | 24,000 | $240.00 | ASP | Q3 2023 – Q4 2026 | ListedMarcaine Spinal |
| 00409-2253-25 | MarcainePfizer Inc | 30 × 25 | 450 | 11,250 | $112.50 | ASP | Q4 2025 – Q4 2026 | ListedMarcaine |
| 00409-2510-25 | MarcainePfizer Inc | 10 × 25 | 50 | 1,250 | $12.50 | ASP | Q1 2026 – Q4 2026 | ListedMarcaine |
| 00409-5010-25 | MarcainePfizer Inc | 10 × 25 | 100 | 2,500 | $25.00 | ASP | Q3 2025 – Q4 2026 | ListedMarcaine |
| 00409-7535-25 | MarcainePfizer Inc | 30 × 25 | 150 | 3,750 | $37.50 | ASP | Q1 2026 – Q4 2026 | ListedMarcaine |
| 70069-0752-25 | Bupivacaine HClSomerset Pharma, LLC | 50 × 25 | 250 | 6,250 | $62.50 | ASP | Q3 2026 – Q4 2026 | ListedBupivacaine Hydrochloride |
| 70594-0114-02 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 10 × 10 | 50 | 500 | $5.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0115-01 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 30 × 1 | 150 | 150 | $1.50 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0116-01 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 50 × 1 | 250 | 250 | $2.50 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0117-02 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 10 × 10 | 100 | 1,000 | $10.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0118-01 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 30 × 1 | 300 | 300 | $3.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0119-01 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 50 × 1 | 500 | 500 | $5.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0120-02 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 10 × 10 | 150 | 1,500 | $15.00 | ASP | Q1 2024 – Q4 2026 | ListedBupivacaine HCl |
| 70594-0121-01 | Bupivacaine HClXellia Pharmaceuticals USA, LLC. | 30 × 1 | 450 | 450 | $4.50 | ASP | Q1 2024 – Q4 2026 | ListedBupivacine HCl |
Derived calculation “Derived $ / NDC” = billable units per NDC × the current payment limit. It is arithmetic for orientation, not a payment amount.
| NDC (11-digit) | CMS drug name · labeler | Pkg size × qty | Units / item | Units / NDC | Crosswalk | Quarters | FDA listing |
|---|---|---|---|---|---|---|---|
| 00404-9908-30 | Bupivicaine w EPIHenry Schein Inc. | 30 × 1 | 150 | 150 | ASP | Q4 2024Not in Q4 2026 file |
Medicare coverage is set nationally (NCDs) and by each Medicare Administrative Contractor (LCDs and Billing & Coding articles). These links open the official documents.
Verification neededCodeRx links to coverage documents instead of copying them: CMS distributes their code lists under AMA, ADA, and AHA license terms that limit reuse. Medicare Advantage, Medicaid, and commercial plans set their own coverage and prior-authorization rules.
Changes detected between the CMS quarterly HCPCS files CodeRx has imported.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q1 2024 | Dates changed | P — Payment change | Added Jul 1, 2023 · action effective Jan 1, 2024 · termination — |
| Q3 2023 | Added to HCPCS | A — Added | Added date Jul 1, 2023 |
All imported releases, checksums, and import reports are listed on the data sources page.
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.
| Apr 1, 2026 – Jun 30, 2026 |
| $0.010 |
| 0.5 MG |
| 20% |
| −9.1% |
| — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.011 | 0.5 MG | 20% | +10.0% | — |
|---|
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.010 | 0.5 MG | 20% | +0.0% | — |
|---|
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $0.010 | 0.5 MG | 20% | +0.0% | — |
|---|
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $0.010 | 0.5 MG | 20% | +0.0% | — |
|---|
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $0.010 | 0.5 MG | 20% | −9.1% | — |
|---|
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $0.011 | 0.5 MG | 20% | +0.0% | — |
|---|
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $0.011 | 0.5 MG | 20% | −26.7% | — |
|---|
| Q2 2024 | Apr 1, 2024 – Jun 30, 2024 | $0.015 | 0.5 MG | 20% | +7.1% | — |
|---|
| Q1 2024 | Jan 1, 2024 – Mar 31, 2024 | $0.014 | 0.5 MG | 20% | −12.5% | — |
|---|
| Q4 2023 | Oct 1, 2023 – Dec 31, 2023 | $0.016 | 0.5 MG | 20% | −23.8% | — |
|---|
| Q3 2023 | Jul 1, 2023 – Sep 30, 2023 | $0.021 | 0.5 MG | 20% | — | Added July 2023 |
|---|
| 00409-1162-10 | Bupivacaine HClPfizer Inc | 30 × 25 | 300 | 7,500 | ASP | Q3 2023 – Q4 2025Not in Q4 2026 file | Excluded listingBupivacaine Hydrochloride |
|---|