In short

CMS assigns Levothyroxine Sodium NDCs to 3 HCPCS codes: J0650 (per 10 mcg), J0651 (per 10 mcg), J0652 (per 10 mcg). Which one applies depends on the product; the table lists each NDC with its code.

J0650 code detailsJ0651 code detailsJ0652 code details

Reference

J0650
Injection, levothyroxine sodium, not otherwise specified, 10 mcgBilling unit: 10 mcg
J0651
Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcgBilling unit: 10 mcg
J0652
Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcgBilling unit: 10 mcg
Labelers
Athenex Pharmaceutical Division, LLC; Endo USA, Inc.; Fosun Pharma USA Inc.; FreseniUS Kabi USA, LLC; Hikma Pharmaceuticals USA Inc.; Sagent Pharmaceuticals; Zydus Pharmaceuticals (Usa) Inc.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$6.581
Per10 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

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$7.079
Per10 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

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$6.315
Per10 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

Levothyroxine Sodium units and claim line

Enter the dose given to get the J0650 units and the NDC line for the CMS-1500 and the 837P. This builds the J0650 line; use the code page for J0651, J0652.

Enter the dose given to build the claim line.

Levothyroxine Sodium 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.

Levothyroxine Sodium NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
25021-0468-10J0650Sagent Pharmaceuticals110
25021-0469-10J0650Sagent Pharmaceuticals120
25021-0470-10J0650Sagent Pharmaceuticals150
42023-0201-01J0650Endo USA, Inc.110
42023-0202-01J0650Endo USA, Inc.120
42023-0203-01J0650Endo USA, Inc.150
63323-0647-10J0650FreseniUS Kabi USA, LLC120
63323-0648-10J0650FreseniUS Kabi USA, LLC150
63323-0649-07J0650FreseniUS Kabi USA, LLC510
63323-0649-16J0650FreseniUS Kabi USA, LLC110
63323-0649-94J0650FreseniUS Kabi USA, LLC510
70710-1833-01J0650Zydus Pharmaceuticals (Usa) Inc.110
70710-1834-01J0650Zydus Pharmaceuticals (Usa) Inc.120
70710-1835-01J0650Zydus Pharmaceuticals (Usa) Inc.150
70860-0451-10J0650Athenex Pharmaceutical Division, LLC110
70860-0452-10J0650Athenex Pharmaceutical Division, LLC120
70860-0453-10J0650Athenex Pharmaceutical Division, LLC150
72266-0261-01J0650Fosun Pharma USA Inc.110
63323-0885-10J0651FreseniUS Kabi USA, LLC510
63323-0885-12J0651FreseniUS Kabi USA, LLC510
63323-0885-14J0651FreseniUS Kabi USA, LLC510
63323-0890-10J0651FreseniUS Kabi USA, LLC520
63323-0895-10J0651FreseniUS Kabi USA, LLC550
24201-0002-01J0652Hikma Pharmaceuticals USA Inc.110

Levothyroxine Sodium: common questions

What is the J-code for Levothyroxine Sodium?
CMS assigns Levothyroxine Sodium NDCs to 3 HCPCS codes: J0650 (per 10 mcg), J0651 (per 10 mcg), J0652 (per 10 mcg). Which one applies depends on the product; the table lists each NDC with its code.
How many J0650 billing units are in a package of Levothyroxine Sodium?
CMS lists 10 to 50 billing units per package, depending on the NDC, where one unit is 10 mcg. Units to report are based on the dose given, not the package.
How many J0651 billing units are in a package of Levothyroxine Sodium?
CMS lists 10 to 50 billing units per package, depending on the NDC, where one unit is 10 mcg. Units to report are based on the dose given, not the package.
How many J0652 billing units are in a package of Levothyroxine Sodium?
CMS lists 10 billing units per package, depending on the NDC, where one unit is 10 mcg. Units to report are based on the dose given, not the package.
Is J0650 a CPT code?
No. J0650 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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