HCPCS drug code · CMS crosswalk
Pentamidine Isethionate J-Code / HCPCS Code
In short
CMS assigns Pentamidine Isethionate NDCs to 2 HCPCS codes: J2516 (per 1 mg), J2545 (per 300 mg). Which one applies depends on the product; the table lists each NDC with its code.
Reference
- J2516
- Injection, pentamidine isethionate, 1 mgBilling unit: 1 mg
- J2545
- Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mgBilling unit: 300 mg
- Labelers
- Heritage Pharmaceuticals Inc.; PAI Holdings, LLC; Seton Pharmaceuticals; XGen Pharmaceuticals DJB, Inc.
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
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
Pentamidine Isethionate units and claim line
Enter the dose given to get the J2516 units and the NDC line for the CMS-1500 and the 837P. This builds the J2516 line; use the code page for J2545.
Enter the dose given to build the claim line.
Pentamidine Isethionate 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 |
|---|---|---|---|---|
| 00121-1101-02 | J2516 | PAI Holdings, LLC | 10 × 1 | 3000 |
| 23155-0748-41 | J2516 | Heritage Pharmaceuticals Inc. | 10 × 1 | 3000 |
| 13925-0522-01 | J2545 | Seton Pharmaceuticals | 1 | 1 |
| 39822-3030-02 | J2545 | XGen Pharmaceuticals DJB, Inc. | 1 | 1 |
Pentamidine Isethionate: common questions
- What is the J-code for Pentamidine Isethionate?
- CMS assigns Pentamidine Isethionate NDCs to 2 HCPCS codes: J2516 (per 1 mg), J2545 (per 300 mg). Which one applies depends on the product; the table lists each NDC with its code.
- How many J2516 billing units are in a package of Pentamidine Isethionate?
- CMS lists 3,000 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
- How many J2545 billing units are in a package of Pentamidine Isethionate?
- CMS lists 1 billing units per package, depending on the NDC, where one unit is 300 mg. Units to report are based on the dose given, not the package.
- Is J2516 a CPT code?
- No. J2516 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.