HCPCS Level II drug code
J3486 — Injection, ziprasidone mesylate, 10 mg
In short
J3486 is the HCPCS Level II code for injection, ziprasidone mesylate, 10 mg. CMS assigns NDCs for Geodon and Ziprasidone Mesylate to it. One billing unit is 10 mg. The Medicare Part B payment limit is $5.94 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, ziprasidone mesylate, 10 mg
- Short descriptor
- Ziprasidone mesylate
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jan 1, 2004
The billing unit is read from the descriptor. Confirm it against the CMS file before billing.
Medicare Part B payment limit
CMS ASP fileEffective 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 mg. For example, 1000 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 J3486
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 9 NDCs to J3486 for Geodon and Ziprasidone Mesylate. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Geodon | 00049-3920-10 | Viatris Specialty LLC | 10 × 1 | 20 |
| Geodon | 50090-4540-00 | A-S Medication Solutions | 1 | 2 |
| Geodon | 58151-0137-81 | Viatris Specialty LLC | 10 × 1 | 20 |
| Ziprasidone Mesylate | 43598-0061-58 | Dr. Reddy's Laboratories Inc. | 10 × 1 | 20 |
| Ziprasidone Mesylate | 43598-0848-58 | Dr. Reddy's Laboratories Inc. | 10 × 1 | 20 |
| Ziprasidone Mesylate | 51662-1564-03 | HF Acquisition Co. LLC, DBA HealthFirst | 10 × 1 | 100 |
| Ziprasidone Mesylate | 72205-0205-07 | Novadoz Pharmaceuticals LLC | 10 × 1 | 20 |
| Ziprasidone Mesylate | 72266-0160-10 | Fosun Pharma USA Inc. | 10 × 1 | 20 |
| Ziprasidone Mesylate | 72266-0160-42 | Fosun Pharma USA Inc. | 10 × 1 | 20 |
J3486: common questions
- Is J3486 a CPT code?
- No. J3486 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 J3486?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 9 NDCs under J3486, for Geodon and Ziprasidone Mesylate. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for J3486?
- $5.94 per 10 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 J3486?
- One unit of J3486 is 10 mg, as stated in the code's descriptor. Units to report = dose given ÷ 10 mg. J-code billing units.