In short

CMS assigns Baclofen NDCs to 2 HCPCS codes: J0475 (per 10 mg), J0476 (per 50 mcg). Which one applies depends on the product; the table lists each NDC with its code.

J0475 code detailsJ0476 code details

Reference

J0475
Injection, baclofen, 10 mgBilling unit: 10 mg
J0476
Injection, baclofen, 50 mcg for intrathecal trialBilling unit: 50 mcg
Labelers
Mylan Institutional LLC; Nexus Pharmaceuticals, LLC; Sagent Pharmaceuticals

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$186.996
Per10 mg
Coinsurance20%

Effective 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

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$46.539
Per50 mcg
Coinsurance20%

Effective 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

Baclofen units and claim line

Enter the dose given to get the J0475 units and the NDC line for the CMS-1500 and the 837P. This builds the J0475 line; use the code page for J0476.

Enter the dose given to build the claim line.

Baclofen 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.

Baclofen NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
14789-0161-05J0475Nexus Pharmaceuticals, LLC204
25021-0678-20J0475Sagent Pharmaceuticals201
25021-0679-20J0475Sagent Pharmaceuticals204
25021-0680-20J0475Sagent Pharmaceuticals202
67457-0564-20J0475Mylan Institutional LLC204
25021-0681-71J0476Sagent Pharmaceuticals2 × 12

Baclofen: common questions

What is the J-code for Baclofen?
CMS assigns Baclofen NDCs to 2 HCPCS codes: J0475 (per 10 mg), J0476 (per 50 mcg). Which one applies depends on the product; the table lists each NDC with its code.
How many J0475 billing units are in a package of Baclofen?
CMS lists 1 to 4 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
How many J0476 billing units are in a package of Baclofen?
CMS lists 2 billing units per package, depending on the NDC, where one unit is 50 mcg. Units to report are based on the dose given, not the package.
Is J0475 a CPT code?
No. J0475 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.

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