HCPCS drug code · CMS crosswalk
Apidra J-Code / HCPCS Code
In short
Apidra is billed under HCPCS J1817 — Insulin for administration through dme (i.e., insulin pump) per 50 units. One billing unit is 50 units. CMS's crosswalk lists 1 Apidra NDC under this code.
Reference
- J1817
- Insulin for administration through dme (i.e., insulin pump) per 50 unitsBilling unit: 50 units
- Labelers
- Sanofi-Aventis U.S. LLC
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Apidra units and claim line
Enter the dose given to get the J1817 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Apidra NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 00088-2500-33 | J1817 | Sanofi-Aventis U.S. LLC | 10 | 20 |
Apidra: common questions
- What is the J-code for Apidra?
- Apidra is billed under HCPCS J1817 — Insulin for administration through dme (i.e., insulin pump) per 50 units. One billing unit is 50 units. CMS's crosswalk lists 1 Apidra NDC under this code.
- How many J1817 billing units are in a package of Apidra?
- CMS lists 20 billing units per package, depending on the NDC, where one unit is 50 units. Units to report are based on the dose given, not the package.
- Is J1817 a CPT code?
- No. J1817 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.