HCPCS drug code · CMS crosswalk
Dalvavancin J-Code / HCPCS Code
In short
Dalvavancin is billed under HCPCS J0875 — Injection, dalbavancin, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 1 Dalvavancin NDC under this code.
Reference
- J0875
- Injection, dalbavancin, 5 mgBilling unit: 5 mg
- Labelers
- FreseniUS Kabi USA, LLC
Medicare Part B payment limit
CMS ASP filePayment limit per unit$9.439
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
Dalvavancin units and claim line
Enter the dose given to get the J0875 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Dalvavancin 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 |
|---|---|---|---|---|
| 65219-0120-12 | J0875 | FreseniUS Kabi USA, LLC | 1 | 100 |
Dalvavancin: common questions
- What is the J-code for Dalvavancin?
- Dalvavancin is billed under HCPCS J0875 — Injection, dalbavancin, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 1 Dalvavancin NDC under this code.
- How many J0875 billing units are in a package of Dalvavancin?
- CMS lists 100 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 J0875 a CPT code?
- No. J0875 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.