In short

J0291 is the HCPCS Level II code for injection, plazomicin, 5 mg. CMS assigns NDCs for Zemdri to it. One billing unit is 5 mg. The Medicare Part B payment limit is $3.519 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ0291
Billing unit5 mg
Descriptor
Injection, plazomicin, 5 mg
Short descriptor
Inj., plazomicin, 5 mg
Code set
HCPCS Level II, maintained by CMS
Effective
Oct 1, 2019

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$3.519
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

Units and claim line

Units = dose given ÷ 5 mg. For example, 500 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under J0291

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J0291 for Zemdri. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0291 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Zemdri69097-0820-96Cipla USA, Inc.10 × 101,000

J0291: common questions

Is J0291 a CPT code?
No. J0291 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J0291?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J0291, for Zemdri. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J0291?
$3.519 per 5 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J0291?
One unit of J0291 is 5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 5 mg. J-code billing units.

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