HCPCS Level II drug code
J0637 — Injection, caspofungin acetate, 5 mg
In short
J0637 is the HCPCS Level II code for injection, caspofungin acetate, 5 mg. CMS assigns NDCs for Cancidas, Caspofungin and Caspofungin Acetate to it. One billing unit is 5 mg. The Medicare Part B payment limit is $2.463 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, caspofungin acetate, 5 mg
- Short descriptor
- Caspofungin acetate
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jan 1, 2024
The billing unit is read from the descriptor. Confirm it against the CMS file before billing.
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
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 J0637
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 14 NDCs to J0637 for Cancidas, Caspofungin and Caspofungin Acetate. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Cancidas | 00006-3822-10 | Merck Sharp & Dohme LLC | 1 | 10 |
| Cancidas | 00006-3823-10 | Merck Sharp & Dohme LLC | 1 | 14 |
| Caspofungin | 72266-0106-01 | Fosun Pharma USA Inc. | 1 | 10 |
| Caspofungin | 72266-0107-01 | Fosun Pharma USA Inc. | 1 | 14 |
| Caspofungin Acetate | 00781-3421-94 | Sandoz Inc. | 1 | 10 |
| Caspofungin Acetate | 00781-3423-94 | Sandoz Inc. | 1 | 14 |
| Caspofungin Acetate | 25021-0194-10 | Sagent Pharmaceuticals | 1 | 10 |
| Caspofungin Acetate | 25021-0195-10 | Sagent Pharmaceuticals | 1 | 14 |
| Caspofungin Acetate | 59923-0613-70 | Areva Pharmaceuticals | 1 | 14 |
| Caspofungin Acetate | 59923-0614-50 | Areva Pharmaceuticals | 1 | 10 |
| Caspofungin Acetate | 63323-0356-10 | FreseniUS Kabi USA, LLC | 10 × 1 | 100 |
| Caspofungin Acetate | 63323-0358-10 | FreseniUS Kabi USA, LLC | 10 × 1 | 140 |
| Caspofungin Acetate | 70860-0106-10 | Athenex Pharmaceutical Division, LLC | 1 | 10 |
| Caspofungin Acetate | 70860-0107-10 | Athenex Pharmaceutical Division, LLC | 1 | 14 |
J0637: common questions
- Is J0637 a CPT code?
- No. J0637 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 J0637?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 14 NDCs under J0637, for Cancidas, Caspofungin and Caspofungin Acetate. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for J0637?
- $2.463 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 J0637?
- One unit of J0637 is 5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 5 mg. J-code billing units.