No. J0476 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.

What NDCs are billed under J0476?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 3 NDCs under J0476, for Baclofen, Gablofen and Lioresal. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J0476?

$46.539 per 50 mcg, 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 J0476?

One unit of J0476 is 50 mcg for intrathecal trial, as stated in the code's descriptor. Units to report = dose given ÷ 50 mcg for intrathecal trial.

J0476 J-Code: Gablofen, Lioresal (baclofen)

In short

J0476 is the HCPCS Level II code for injection, baclofen, 50 mcg for intrathecal trial. CMS assigns NDCs for Baclofen, Gablofen and Lioresal to it. One billing unit is 50 mcg for intrathecal trial. The Medicare Part B payment limit is $46.539 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ0476

Billing unit50 mcg for intrathecal trial

Descriptor: Injection, baclofen, 50 mcg for intrathecal trial
Short descriptor: Baclofen intrathecal trial
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 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$46.539

Per50 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

Units and claim line

Units = dose given ÷ 50 mcg for intrathecal trial. For example, 5000 mcg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Dose given (mcg)

HCPCS units (1 unit = 50 mcg)

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the dose given to build the claim line.

NDCs billed under J0476

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 3 NDCs to J0476 for Baclofen, Gablofen and Lioresal. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0476 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Baclofen	25021-0681-71	Sagent Pharmaceuticals	2 × 1	2
Gablofen	66794-0151-01	Piramal Critical Care Inc	1	1
Lioresal	70121-2496-05	Amneal Pharmaceuticals, LLC	5 × 1	5

J0476: common questions

Is J0476 a CPT code?: No. J0476 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 J0476?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 3 NDCs under J0476, for Baclofen, Gablofen and Lioresal. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J0476?: $46.539 per 50 mcg, 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 J0476?: One unit of J0476 is 50 mcg for intrathecal trial, as stated in the code's descriptor. Units to report = dose given ÷ 50 mcg for intrathecal trial. J-code billing units.

J0476 — Injection, baclofen, 50 mcg for intrathecal trial