HCPCS drug code · CMS crosswalk
Rapamune J-Code / HCPCS Code
In short
Rapamune is billed under HCPCS J7520 — Sirolimus, oral, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Rapamune NDCs under this code.
Reference
- J7520
- Sirolimus, oral, 1 mgBilling unit: 1 mg
- Labelers
- Pfizer Inc
Medicare Part B payment limit
CMS ASP filePayment limit per unit$0.609
Per1 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
Rapamune units and claim line
Enter the dose given to get the J7520 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Rapamune 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 |
|---|---|---|---|---|
| 00008-1041-05 | J7520 | Pfizer Inc | 100 | 100 |
| 00008-1042-05 | J7520 | Pfizer Inc | 100 | 200 |
Rapamune: common questions
- What is the J-code for Rapamune?
- Rapamune is billed under HCPCS J7520 — Sirolimus, oral, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Rapamune NDCs under this code.
- How many J7520 billing units are in a package of Rapamune?
- CMS lists 100 to 200 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.
- Is J7520 a CPT code?
- No. J7520 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.