HCPCS drug code · CMS crosswalk
Caspofungin J-Code / HCPCS Code
In short
Caspofungin is billed under HCPCS J0637 — Injection, caspofungin acetate, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 2 Caspofungin NDCs under this code.
Reference
- J0637
- Injection, caspofungin acetate, 5 mgBilling unit: 5 mg
- Labelers
- Fosun Pharma USA Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$2.463
Per5 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
Caspofungin units and claim line
Enter the dose given to get the J0637 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Caspofungin 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 |
|---|---|---|---|---|
| 72266-0106-01 | J0637 | Fosun Pharma USA Inc. | 1 | 10 |
| 72266-0107-01 | J0637 | Fosun Pharma USA Inc. | 1 | 14 |
Caspofungin: common questions
- What is the J-code for Caspofungin?
- Caspofungin is billed under HCPCS J0637 — Injection, caspofungin acetate, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 2 Caspofungin NDCs under this code.
- How many J0637 billing units are in a package of Caspofungin?
- CMS lists 10 to 14 billing units per package, depending on the NDC, where one unit is 5 mg. Units to report are based on the dose given, not the package.
- Is J0637 a CPT code?
- No. J0637 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.