In short

J0650 is the HCPCS Level II code for injection, levothyroxine sodium, not otherwise specified, 10 mcg: drugs with no specific code of their own. It has no fixed drug or unit, so the claim carries the NDC of the drug given and its quantity.

Code

CMS HCPCS file
HCPCS codeJ0650
Billing unit10 mcg
Descriptor
Injection, levothyroxine sodium, not otherwise specified, 10 mcg
Short descriptor
Inj, levothyroxine nos 10mcg
Code set
HCPCS Level II, maintained by CMS
Effective
Apr 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 file
Payment limit per unit$6.581
Per10 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

Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the units to build the claim line.

NDCs billed under J0650

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 18 NDCs to J0650 for Levothyroxine Sodium. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0650 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Levothyroxine Sodium25021-0468-10Sagent Pharmaceuticals110
Levothyroxine Sodium25021-0469-10Sagent Pharmaceuticals120
Levothyroxine Sodium25021-0470-10Sagent Pharmaceuticals150
Levothyroxine Sodium42023-0201-01Endo USA, Inc.110
Levothyroxine Sodium42023-0202-01Endo USA, Inc.120
Levothyroxine Sodium42023-0203-01Endo USA, Inc.150
Levothyroxine Sodium63323-0647-10FreseniUS Kabi USA, LLC120
Levothyroxine Sodium63323-0648-10FreseniUS Kabi USA, LLC150
Levothyroxine Sodium63323-0649-07FreseniUS Kabi USA, LLC510
Levothyroxine Sodium63323-0649-16FreseniUS Kabi USA, LLC110
Levothyroxine Sodium63323-0649-94FreseniUS Kabi USA, LLC510
Levothyroxine Sodium70710-1833-01Zydus Pharmaceuticals (Usa) Inc.110
Levothyroxine Sodium70710-1834-01Zydus Pharmaceuticals (Usa) Inc.120
Levothyroxine Sodium70710-1835-01Zydus Pharmaceuticals (Usa) Inc.150
Levothyroxine Sodium70860-0451-10Athenex Pharmaceutical Division, LLC110
Levothyroxine Sodium70860-0452-10Athenex Pharmaceutical Division, LLC120
Levothyroxine Sodium70860-0453-10Athenex Pharmaceutical Division, LLC150
Levothyroxine Sodium72266-0261-01Fosun Pharma USA Inc.110

J0650: common questions

Is J0650 a CPT code?
No. J0650 is a HCPCS Level II code, maintained by CMS, that identifies a drug with no specific code of its own. 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 NDC goes with J0650?
None is fixed. J0650 is used for drugs that have no specific HCPCS code, so the claim carries the NDC of the drug actually given and its quantity, and payers usually also ask for the drug name and dose. How to find a J-code.
What is the Medicare payment limit for J0650?
$6.581 per 10 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.

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