In short

J3111 is the HCPCS Level II code for injection, romosozumab-aqqg, 1 mg. CMS assigns NDCs for Evenity to it. One billing unit is 1 mg. The Medicare Part B payment limit is $12.792 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ3111
Billing unit1 mg
Descriptor
Injection, romosozumab-aqqg, 1 mg
Short descriptor
Inj. romosozumab-aqqg 1 mg
Code set
HCPCS Level II, maintained by CMS
Effective
Oct 1, 2019

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$12.792
Per1 mg
Coinsurance18.523%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Inflation-adjusted coinsurance. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Units = dose given ÷ 1 mg. For example, 100 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 J3111

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J3111 for Evenity. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J3111 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Evenity55513-0880-02Amgen Inc2 × 1.17210
Evenity55513-0998-02Amgen Inc2 × 1.17210

J3111: common questions

Is J3111 a CPT code?
No. J3111 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 J3111?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J3111, for Evenity. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J3111?
$12.792 per 1 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 J3111?
One unit of J3111 is 1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 1 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