In short

J1163 is the HCPCS Level II code for injection, diltiazem hydrochloride, 0.5 mg. CMS assigns NDCs for Diltiazem HCl, Diltiazem in Dextrose and Diltiazem in NaCl to it. One billing unit is 0.5 mg. The Medicare Part B payment limit is $0.027 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ1163
Billing unit0.5 mg
Descriptor
Injection, diltiazem hydrochloride, 0.5 mg
Short descriptor
Inj, diltiazem hcl, 0.5 mg
Code set
HCPCS Level II, maintained by CMS
Effective
Jul 1, 2025

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$0.027
Per0.5 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 ÷ 0.5 mg. For example, 50 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 J1163

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 20 NDCs to J1163 for Diltiazem HCl, Diltiazem in Dextrose and Diltiazem in NaCl. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J1163 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Diltiazem HCl00409-4350-03Pfizer Inc10 × 12,000
Diltiazem HCl00641-6013-10Hikma Pharmaceuticals USA Inc.10 × 5500
Diltiazem HCl00641-6014-10Hikma Pharmaceuticals USA Inc.10 × 101,000
Diltiazem HCl00641-6015-10Hikma Pharmaceuticals USA Inc.10 × 252,500
Diltiazem HCl00641-9217-10Hikma Pharmaceuticals USA Inc.10 × 5500
Diltiazem HCl00641-9218-10Hikma Pharmaceuticals USA Inc.10 × 101,000
Diltiazem HCl00641-9219-10Hikma Pharmaceuticals USA Inc.10 × 252,500
Diltiazem HCl25021-0319-05Sagent Pharmaceuticals10 × 5500
Diltiazem HCl25021-0319-10Sagent Pharmaceuticals10 × 101,000
Diltiazem HCl25021-0319-25Sagent Pharmaceuticals10 × 252,500
Diltiazem HCl51662-1335-01HF Acquisition Co. LLC, DBA HealthFirst550
Diltiazem HCl51662-1335-02HF Acquisition Co. LLC, DBA HealthFirst550
Diltiazem HCl51662-1457-01HF Acquisition Co. LLC, DBA HealthFirst1200
Diltiazem HCl51662-1457-03HF Acquisition Co. LLC, DBA HealthFirst10 × 12,000
Diltiazem HCl55150-0425-10Eugia US LLC10 × 5500
Diltiazem HCl55150-0426-10Eugia US LLC10 × 101,000
Diltiazem HCl55150-0427-10Eugia US LLC10 × 252,500
Diltiazem HCl70860-0301-05Athenex Pharmaceutical Division, LLC10 × 5500
Diltiazem in Dextrose63037-0119-05Hikma Injectables USA Inc.5 × 1251,250
Diltiazem in NaCl63037-0117-05Hikma Injectables USA Inc.5 × 1251,250

J1163: common questions

Is J1163 a CPT code?
No. J1163 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 J1163?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 20 NDCs under J1163, for Diltiazem HCl, Diltiazem in Dextrose and Diltiazem in NaCl. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J1163?
$0.027 per 0.5 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 J1163?
One unit of J1163 is 0.5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.5 mg. J-code billing units.

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