In short

J1326 is the HCPCS Level II code for injection, zolbetuximab-clzb, 2 mg. CMS assigns NDCs for Vyloy to it. One billing unit is 2 mg. The Medicare Part B payment limit is $33.919 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ1326
Billing unit2 mg
Descriptor
Injection, zolbetuximab-clzb, 2 mg
Short descriptor
Inj, zolbetuximab-clzb, 2 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$33.919
Per2 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 ÷ 2 mg. For example, 200 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 J1326

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J1326 for Vyloy. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J1326 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Vyloy00469-3425-10Astellas Pharma US, Inc.150
Vyloy00469-4425-30Astellas Pharma US, Inc.1150

J1326: common questions

Is J1326 a CPT code?
No. J1326 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 J1326?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J1326, for Vyloy. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J1326?
$33.919 per 2 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 J1326?
One unit of J1326 is 2 mg, as stated in the code's descriptor. Units to report = dose given ÷ 2 mg. J-code billing units.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free Med-Code account to keep looking up NDCs, J-codes and drugs.

Create a free accountLog in