HCPCS drug code · CMS crosswalk
Phenytoin Sodium J-Code / HCPCS Code
In short
Phenytoin Sodium is billed under HCPCS J1165 — Injection, phenytoin sodium, per 50 mg. One billing unit is 50 mg. CMS's crosswalk lists 9 Phenytoin Sodium NDCs under this code.
Reference
- J1165
- Injection, phenytoin sodium, per 50 mgBilling unit: 50 mg
- Labelers
- HF Acquisition Co. LLC, DBA HealthFirst; Henry Schein Inc.; Hikma Pharmaceuticals USA Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$0.513
Per50 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
Phenytoin Sodium units and claim line
Enter the dose given to get the J1165 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Phenytoin 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.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 00404-9808-05 | J1165 | Henry Schein Inc. | 5 | 5 |
| 00404-9932-02 | J1165 | Henry Schein Inc. | 2 | 2 |
| 00404-9933-05 | J1165 | Henry Schein Inc. | 5 | 5 |
| 00641-0493-25 | J1165 | Hikma Pharmaceuticals USA Inc. | 25 × 2 | 50 |
| 00641-2555-10 | J1165 | Hikma Pharmaceuticals USA Inc. | 10 × 5 | 50 |
| 00641-6138-25 | J1165 | Hikma Pharmaceuticals USA Inc. | 25 × 2 | 50 |
| 00641-6139-10 | J1165 | Hikma Pharmaceuticals USA Inc. | 10 × 5 | 50 |
| 51662-1251-01 | J1165 | HF Acquisition Co. LLC, DBA HealthFirst | 2 | 2 |
| 51662-1251-03 | J1165 | HF Acquisition Co. LLC, DBA HealthFirst | 25 × 2 | 50 |
Phenytoin Sodium: common questions
- What is the J-code for Phenytoin Sodium?
- Phenytoin Sodium is billed under HCPCS J1165 — Injection, phenytoin sodium, per 50 mg. One billing unit is 50 mg. CMS's crosswalk lists 9 Phenytoin Sodium NDCs under this code.
- How many J1165 billing units are in a package of Phenytoin Sodium?
- CMS lists 2 to 50 billing units per package, depending on the NDC, where one unit is 50 mg. Units to report are based on the dose given, not the package.
- Is J1165 a CPT code?
- No. J1165 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.