In short

J3396 is the HCPCS Level II code for injection, verteporfin, 0.1 mg. CMS assigns NDCs for Visudyne to it. One billing unit is 0.1 mg. The Medicare Part B payment limit is $11.342 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ3396
Billing unit0.1 mg
Descriptor
Injection, verteporfin, 0.1 mg
Short descriptor
Verteporfin injection
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2005

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$11.342
Per0.1 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 ÷ 0.1 mg. For example, 10 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 J3396

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J3396 for Visudyne. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J3396 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Visudyne00187-5600-15Bausch & Lomb Americas Inc.1150
Visudyne24208-0560-15Bausch & Lomb Americas Inc.1150

J3396: common questions

Is J3396 a CPT code?
No. J3396 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 J3396?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J3396, for Visudyne. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J3396?
$11.342 per 0.1 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 J3396?
One unit of J3396 is 0.1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.1 mg. J-code billing units.

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