In short

J1786 is the HCPCS Level II code for injection, imiglucerase, 10 units. CMS assigns NDCs for Cerezyme to it. One billing unit is 10 units. The Medicare Part B payment limit is $43.203 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ1786
Billing unit10 units
Descriptor
Injection, imiglucerase, 10 units
Short descriptor
Imuglucerase injection
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2011

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$43.203
Per10 units
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 ÷ 10 units. For example, 1000 units 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 J1786

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J1786 for Cerezyme. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J1786 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Cerezyme58468-4663-01Genzyme Corporation140

J1786: common questions

Is J1786 a CPT code?
No. J1786 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 J1786?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J1786, for Cerezyme. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J1786?
$43.203 per 10 units, 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 J1786?
One unit of J1786 is 10 units, as stated in the code's descriptor. Units to report = dose given ÷ 10 units. J-code billing units.

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