No. J0875 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 is the Medicare payment limit for J0875?

$9.439 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 J0875?

One unit of J0875 is 5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 5 mg.

J0875 J-Code: Dalbavancin — Billing Units & NDCs

In short

J0875 is the HCPCS Level II code for injection, dalbavancin, 5 mg. CMS assigns NDCs for Dalbavacin HCl, Dalbavancin, Dalvance and Dalvavancin to it. One billing unit is 5 mg. The Medicare Part B payment limit is $9.439 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ0875

Billing unit5 mg

Descriptor: Injection, dalbavancin, 5 mg
Short descriptor: Injection, dalbavancin
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 2016

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$9.439

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.

Dose given (mg)

HCPCS units (1 unit = 5 mg)

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the dose given to build the claim line.

NDCs billed under J0875

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 5 NDCs to J0875 for Dalbavacin HCl, Dalbavancin, Dalvance and Dalvavancin. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J0875 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Dalbavacin HCl	00480-3325-01	Teva Pharmaceuticals USA, Inc.	1	100
Dalbavancin	71288-0034-50	Meitheal Pharmaceuticals Inc.	1	100
Dalbavancin	81298-2390-01	Long Grove Pharmaceuticals, LLC	1	100
Dalvance	57970-0100-01	Allergan, Inc.	1	100
Dalvavancin	65219-0120-12	FreseniUS Kabi USA, LLC	1	100

J0875: common questions

Is J0875 a CPT code?: No. J0875 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 J0875?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 5 NDCs under J0875, for Dalbavacin HCl, Dalbavancin, Dalvance and Dalvavancin. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J0875?: $9.439 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 J0875?: One unit of J0875 is 5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 5 mg. J-code billing units.

J0875 — Injection, dalbavancin, 5 mg