Descriptors and administrative fields exactly as published in the CMS HCPCS quarterly file.
Billing context: J-codes
Units are reported in multiples of the dosage in the code descriptor.
One HCPCS billing unit of J2151
250 MG
Medicare payment limit per unit (Q4 2026): $0.112
No published MUE for J2151. 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
$0.112per 250 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 | $0.112 | 250 MG | 20% | +57.7% | — |
| Q3 2026 | Jul 1, 2026 – Sep 30, 2026 | $0.071 | 250 MG | 20% | +34.0% | — |
| Q2 2026 | Apr 1, 2026 – Jun 30, 2026 | $0.053 | 250 MG | 20% | −11.7% | — |
| Q1 2026 | Jan 1, 2026 – Mar 31, 2026 | $0.060 | 250 MG | 20% |
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 |
|---|---|---|---|---|---|---|---|---|
| 63323-0024-25 | MannitolFreseniUS Kabi USA, LLC | 50 × 25 | 50 | 50 | $5.60 | ASP | Q4 2025 – Q4 2026 | ListedMANNITOL |
| 00404-9905-50 | MannitolHenry Schein Inc. | 50 × 1 | 50 | 50 | $5.60 | ASP | Q4 2025 – Q4 2026 | ListedMANNITOL |
| 51662-1468-01 | MannitolHF Acquisition Co. LLC, DBA HealthFirst | 50 × 1 | 50 | 50 | $5.60 | ASP | Q4 2025 – Q4 2026 | ListedMANNITOL |
| 51662-1468-03 | MannitolHF Acquisition Co. LLC, DBA HealthFirst | 50 × 25 | 50 | 1,250 | $140.00 | ASP | Q4 2025 – Q4 2026 | ListedMANNITOL |
| 00990-7715-02 | MannitolICu Medical Inc. | 250 × 24 | 200 | 4,800 | $537.60 | ASP | Q1 2026 – Q4 2026 | ListedMANNITOL |
| 00990-7715-03 | MannitolICu Medical Inc. | 500 × 12 | 400 | 4,800 | $537.60 | ASP | Q1 2026 – Q4 2026 | ListedMANNITOL |
| 00409-4031-01 | MannitolPfizer Inc | 50 × 25 | 50 | 1,250 | $140.00 | ASP | Q4 2025 – Q4 2026 | ListedMANNITOL |
Derived calculation “Derived $ / NDC” = billable units per NDC × the current payment limit. It is arithmetic for orientation, not a payment amount.
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 |
|---|---|---|---|
| Q4 2025 | Added to HCPCS | A — Added | Added date Oct 1, 2025 |
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.
| −1.6% |
| — |
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $0.061 | 250 MG | 20% | — | Added October 2025 |
|---|