CareCost Optimizer / Margin Watch / New J-Codes & DrugsChange Tracker · updated every CMS quarter
New & Deleted J-Codes, Quarter by Quarter Every drug code that entered or left the Medicare Part B payment-limit file, with drug names — the codes where pricing is newest, spreads are widest, and billing systems lag the most. Last 8 quarterly files, newest first.
Latest = preliminary file Source: CMS quarterly payment-limit files (set-difference per quarter pair) Full price moves on existing codes: the ASP-change leaderboard July 2026 file +10 added · −8 deleted · 690 existing limits changed
Added (10)
J0681 Inj ceftobipole medocarl 3mg J7674 Methacholine chloride, neb J9053 Inj belantamab mafodot blmf J9062 Inj amivantamab 5mg hyaluron J9161 Inj denileuk difti-cxdl 1mcg J9174 Inj, docetaxel (beizray) 1mg J9232 Inj docetaxel (hospira) 1 mg Q0234 Inj, tocilizumab-bavi, 1mg Q5098 Inj ustekinumab-srlf, 1 mg Q5160 Inj, jobevne, 10 mg Deleted (8)
J0565 Inj, bezlotoxumab, 10 mg J7314 Inj., yutiq, 0.01 mg J9196 Inj gemcitabine hcl (accord) J9295 Injection, necitumumab, 1 mg J9296 Inj pemetrexed (accord) 10mg J9318 Inj romidepsin non-lyo 0.1mg Q5126 Inj alymsys 10 mg Q5128 Inj, cimerli, 0.1 mg April 2026 file +21 added · −9 deleted · 666 existing limits changed
Added (21)
J0463 Inj atropine (fresenius te) J0759 Inj, clevidipine, 1 mg J1164 Inj diltiazem in 0.72% nacl J1553 Inj yimmugo 100 mg J1612 Inj glucagon (gvoke) 0.01 mg J2545 Pentamidine non-comp unit J8502 Inj, aponvie, 1 mg J8515 Cabergoline, oral 0.25mg J9183 Gemcitabine intravesical sys J9184 Inj gemcitabin (avyxa) 200mg J9277 Pembrolizumab 1mg berahyalur J9278 Inj, carboplatin (avyxa) J9282 Mitomycin intravesical inst J9601 Inj linvoseltamab-gcpt 1 mg Q0237 Inj, tocilizumab-anoh, hospi Q0238 Inj, tocilizumab-aazg, hospi Q5134 Inj, tyruko, 1 mg Q5156 Inj, tocilizumab-anoh, 1 mg Q5157 Inj, denosumab-bmwo, 1 mg Q5158 Inj, denosumab-bnht, 1 mg Q5162 Inj, denosumab-nxxp, 1 mg Deleted (9)
J0841 Inj crotalidae im f(ab')2 eq J0893 Inj, decitabine (sun pharma) J2313 Inj, naloxone (zimhi) 0.01mg J3471 Ovine, up to 999 usp units J7674 Methacholine chloride, neb J8670 Rolapitant, oral, 1mg J9202 Goserelin acetate implant J9323 Inj pemetrexed ditromethamin Q4074 Iloprost non-comp unit dose January 2026 file +20 added · −155 deleted · 659 existing limits changed
Added (20)
J0162 Inj epinephrine (fresenius) J0164 Epinephrine in nacl (baxter) J0458 Aztreonam/avibactam 10 mg J1307 Inj, crovalimab-akkz, 10 mg J1597 Inj glycopyrrolate, glyrx-pf J1837 Inj, posaconazole, 1 mg J2516 Pentamidine non-comp unit J2596 Vasopressin (long grove) 1 u J3376 Inj vancomycin (hikma) 10mg J3379 Inj, valproate sod, 5 mg J7174 Injection fitusiran 0.04 mg J7514 Mycophenol (myhibbin) 100 mg J7528 Mycophen mofetil for susp J9256 Inj, nipocalimab-aahu, 3 mg J9326 Telisotuzumab vedotin-tllv J9341 Inj thiotepa (tepylute) 1 mg Q5136 Inj. denosumab-bbdz, 1 mg Q5148 Inj, nyposi 1 mcg Q5151 Inj, eculizumab-aagh, 2 mg Q5152 Inj, eculizumab-aeeb, 2 mg Deleted (155)
J0172 Inj, aducanumab-avwa, 2 mg J0287 Amphotericin b lipid complex J2545 Pentamidine non-comp unit Q4101 Apligraf Q4102 Oasis wound matrix Q4103 Oasis burn matrix Q4104 Integra bmwd Q4105 Integra drt or omnigraft Q4108 Integra matrix Q4110 Primatrix Q4111 Gammagraft Q4114 Integra flowable wound matri Q4115 Alloskin Q4118 Matristem micromatrix Q4121 Theraskin Q4123 Alloskin Q4124 Oasis tri-layer wound matrix Q4126 Memoderm/derma/tranz/integup Q4127 Talymed Q4128 Flexhd/allopatchhd/sq cm Q4132 Grafix core, grafixpl core Q4133 Grafix stravix prime pl sqcm Q4137 Amnioexcel biodexcel 1sq cm Q4138 Biodfence dryflex, 1cm Q4140 Biodfence 1cm Q4141 Alloskin ac, 1 cm Q4143 Repriza, 1cm Q4145 Epifix, inj, 1mg Q4148 Neox neox rt or clarix cord Q4150 Allowrap ds or dry 1 sq cm Q4151 Amnioband, guardian 1 sq cm Q4152 Dermapure 1 square cm Q4153 Dermavest, plurivest sq cm Q4154 Biovance 1 square cm Q4155 Neoxflo or clarixflo 1 mg Q4156 Neox 100 or clarix 100 Q4158 Kerecis omega3, per sq cm Q4159 Affinity1 square cm Q4160 Nushield 1 square cm Q4161 Bio-connekt per square cm Q4163 Woundex, bioskin, per sq cm Q4164 Helicoll, per square cm Q4166 Cytal, per square centimeter Q4169 Artacent wound, per sq cm Q4170 Cygnus, per sq cm Q4171 Interfyl, 1 mg Q4173 Palingen or palingen xplus Q4175 Miroderm Q4178 Floweramniopatch, per sq cm Q4180 Revita, per sq cm Q4184 Cellesta or duo per sq cm Q4186 Epifix 1 sq cm Q4187 Epicord 1 sq cm Q4188 Amnioarmor 1 sq cm Q4190 Artacent ac 1 sq cm Q4191 Restorigin 1 sq cm Q4193 Coll-e-derm 1 sq cm Q4194 Novachor 1 sq cm Q4195 Puraply 1 sq cm Q4196 Puraply am 1 sq cm Q4197 Puraply xt 1 sq cm Q4199 Cygnus matrix, per sq cm Q4201 Matrion 1 sq cm Q4203 Derma-gide, 1 sq cm Q4204 Xwrap 1 sq cm Q4205 Membrane graft or wrap sq cm Q4217 Woundfix biowound plus xplus Q4221 Amniowrap2 per sq cm Q4222 Progenamatrix, per sq cm Q4225 Amnio or derma tl, per sq cm Q4227 Amniocore per sq cm Q4229 Cogenex amnio memb per sq cm Q4232 Corplex, per sq cm Q4234 Xcellerate, per sq cm Q4235 Amniorepair or altiply sq cm Q4236 Carepatch per sq cm Q4238 Derm-maxx, per sq cm Q4239 Amnio-maxx or lite per sq cm Q4248 Dermacyte amn mem allo sq cm Q4249 Amniply, per sq cm Q4250 Amnioamp-mp per sq cm Q4252 Vendaje, per square centimet Q4253 Zenith amniotic membrane psc Q4256 Mlg complet, per sq cm Q4257 Relese, per sq cm Q4258 Enverse, per sq cm Q4259 Celera per sq cm Q4262 Dual layer impax, per sq cm Q4263 Surgraft tl, per sq cm Q4264 Cocoon membrane, per sq cm Q4265 Neostim tl per sq cm Q4266 Neostim per sq cm Q4267 Neostim dl per sq cm Q4268 Surgraft ft per sq cm Q4269 Surgraft xt per sq cm Q4270 Complete sl per sq cm Q4271 Complete ft per sq cm Q4274 Esano ac, per sq cm Q4275 Esano aca, per sq cm Q4276 Orion, per sq cm Q4278 Epieffect, per sq cm Q4279 Vendaje ac, per sq cm Q4280 Xcell amnio matrix per sq cm Q4281 Barrera slor dl per sq cm Q4282 Cygnus dual per sq cm Q4283 Biovance tri or 3l, sq cm Q4289 Revoshield+ amnio, per sq cm Q4290 Membrane wrap hydr per sq cm Q4293 Acesso dl, per sq cm Q4294 Amnio quad-core, per sq cm Q4295 Amnio tri-core, per sq cm Q4296 Rebound matrix, per sq cm Q4297 Emerge matrix, per sq cm Q4298 Amnicore pro, per sq cm Q4299 Amnicore pro+, per sq cm Q4300 Acesso tl, per sq cm Q4301 Activate matrix, per sq cm Q4302 Complete aca, per sq cm Q4303 Complete aa, per sq cm Q4304 Grafix plus, per sq cm Q4309 Via matrix, per sq cm Q4310 Procenta, per 100 mg Q4312 Acesso ac, per sq cm Q4313 Dermabind fm, per sq cm Q4314 Reeva, per sq cm Q4316 Amchoplast, per sq cm Q4317 Vitograft, per sq cm Q4319 Sanograft, per sq cm Q4320 Pellograft, per sq cm Q4321 Renograft, per sq cm Q4322 Caregraft, per sq cm Q4323 Alloply, per sq cm Q4325 Acapatch, per sq cm Q4326 Woundplus, per sq cm Q4328 Most, per sq cm Q4331 Axolotl graft, per sq cm Q4332 Axolotl dualgraft, per sq cm Q4339 Artacent vericlen, per sq cm Q4340 Simpligraft, per sq cm Q4341 Simplimax, per sq cm Q4342 Theramend, per sq cm Q4343 Dermacyte ac matrx per sq cm Q4344 Tri membrane wrap, per sq cm Q4345 Matrix hd allogrft per sq cm Q4346 Shelter dm matrix per sq cm Q4347 Rampart dl matrix per sq cm Q4348 Sentry sl matrix per sq cm Q4350 Palisade dm matrix per sq cm Q4353 Xceed tl matrix per sq cm Q4355 Abio xpl abio xpl hy p sq cm Q4357 Xwrap plus, per sq cm Q4358 Xwrap dual, per sq cm Q4359 Choriply, per sq cm Q4361 Epixpress, per sq cm Q4367 Amniocore sl, per sq cm October 2025 file +43 added · −1 deleted · 763 existing limits changed
Added (43)
J0163 Epinephrine in nacl (endo) J0462 Atropine sulf, nte, 0.01 mg J0582 Bivalirudin (endo) 1 mg J0614 Inj, treosulfan, 50 mg J0738 Hiv prep, inj, lenacapavir J0752 Hiv prep, oral lenacapavir J0901 Vadadustat oral 1mg for esrd J1809 Inj, fosdenopterin, 0.1mg J2151 Inj, mannitol, 250 mg J2291 Inj, nafcillin (baxter) 20mg J2428 Inj, erzofri, 1 mg J3402 Inj. remestemcel-l-rknd/ td J7173 Inj. concizumab-mtci, 0.5 mg J7356 Inj foscarb/foslevodopa 5 mg J9011 Datopotamab deruxtecan, 1 mg J9038 Inj axatilimab-csfr 0.1 mg J9054 Inj bortezomib boruzu 0.1 mg J9289 Inj nivolumab 2 mg hyaluron J9382 Inj zenocutuzumab-zbco 1 mg Q4268 Surgraft ft per sq cm Q4269 Surgraft xt per sq cm Q4312 Acesso ac, per sq cm Q4314 Reeva, per sq cm Q4317 Vitograft, per sq cm Q4319 Sanograft, per sq cm Q4320 Pellograft, per sq cm Q4321 Renograft, per sq cm Q4340 Simpligraft, per sq cm Q4345 Matrix hd allogrft per sq cm Q4346 Shelter dm matrix per sq cm Q4347 Rampart dl matrix per sq cm Q4348 Sentry sl matrix per sq cm Q4350 Palisade dm matrix per sq cm Q4353 Xceed tl matrix per sq cm Q4355 Abio xpl abio xpl hy p sq cm Q4358 Xwrap dual, per sq cm Q4359 Choriply, per sq cm Q5099 Inj ustekinumab-stba, 1 mg Q5100 Inj ustekinumab-kfce, 1 mg Q5138 Inj, wezlana, iv, 1 mg Q9997 Ustekinumab-ttwe iv inj 1 mg Q9998 Inj ustekinumab-aekn, 1 mg Q9999 Inj ustekinumab-aauz 1 mg July 2025 file +40 added · −12 deleted · 756 existing limits changed
Added (40)
J0165 Inj epinephrine nos 0.1 mg J0166 Inj epinephrine (bpi) J0167 Inj epinephrine (hospira) J0168 Epinephrine (intl med sys) J0169 Inj epinephrine (adrenalin) J0616 Inj metoprolol tartrate 1 mg J1072 Inj, testosterone, azmiro J1163 Inj, diltiazem hcl, 0.5 mg J1326 Inj, zolbetuximab-clzb, 2 mg J1749 Inj, iloprost, 0.1 mcg J2290 Inj, nafcillin sodium, 20 mg J2312 Inj naloxone hcl nos, 0.01mg J2313 Inj, naloxone (zimhi) 0.01mg J3373 Inj, vancomycin hcl, 10 mg J3374 Inj, vancomycin (mylan) 10mg J3375 Inj vancomycin (xellia) 10mg J7172 Inj marstacim-hncq, 0.5 mg J8611 Oral methotrexate (jylamvo) J8612 Oral methotrexate (xatmep) J9076 Inj, cyclophos (baxter) 5mg J9276 Inj zanidatamab-hrii, 2 mg J9292 Inj, pemetrexed dipotassium J9318 Inj romidepsin non-lyo 0.1mg J9329 Inj, tislelizumab-jsgr J9342 Inj thiotepa nos 1 mg Q2057 Afamitresgene autoleucel Q4145 Epifix, inj, 1mg Q4169 Artacent wound, per sq cm Q4249 Amniply, per sq cm Q4316 Amchoplast, per sq cm Q4326 Woundplus, per sq cm Q4331 Axolotl graft, per sq cm Q4339 Artacent vericlen, per sq cm Q4341 Simplimax, per sq cm Q4342 Theramend, per sq cm Q4344 Tri membrane wrap, per sq cm Q4357 Xwrap plus, per sq cm Q4361 Epixpress, per sq cm Q4367 Amniocore sl, per sq cm Q5146 Inj, hercessi, 10 mg Deleted (12)
J0171 Adrenalin epinephrine inject J0173 Inj, epinephrine (belcher) J1744 Icatibant injection J2310 Inj naloxone hydrochloride J2311 Inj, naloxone hcl (zimhi) J3370 Vancomycin hcl injection J3371 Inj, vancomycin hcl (mylan) J3372 Inj, vancomycin hcl (xellia) J9340 Thiotepa injection Q4231 Corplex p, per cc Q4269 Surgraft xt per sq cm Q4319 Sanograft, per sq cm April 2025 file +72 added · −7 deleted · 698 existing limits changed
Added (72)
J0138 Inj acetaminoph 10mg/ibu 3mg J0281 Inj aminocaproic acid 1 gram J0287 Amphotericin b lipid complex J0589 Inj daxibotulinumtoxina-lanm J0593 Inj., lanadelumab-flyo, 1 mg J0870 Injection, imetelstat, 1 mg J0883 Argatroban nonesrd use 1mg J0893 Inj, decitabine (sun pharma) J0898 Argatroban nonesrd (auromed) J0899 Argatroban dialysis, auromed J1271 Inj doxycycline hyclate 1 mg J1299 Inj, eculizumab, 2 mg J1308 Inj, famotidine, 0.25 mg J1434 Inj, focinvez, 1mg J1744 Icatibant injection J1790 Droperidol injection J1808 Inj, folic acid, 0.1 mg J1938 Inj, furosemide, 1 mg J2246 Inj, micafungin (baxter) J2351 Inj ocrelizumab 1mg hya-ocsq J2371 Inj phenylephrine hcl 20 mcg J2468 Inj, palonosetron (posfrea) J2502 Inj, pasireotide long acting J2804 Inj, rifampin, 1 mg J2865 Inj sulfameth/trim 5 mg/1 mg J3300 Triamcinolone a inj prs-free J3316 Inj., triptorelin xr 3.75 mg J3471 Ovine, up to 999 usp units J7355 Inj travoprost intra impl J7521 Tacrolim granules oral susp J7601 Ensifentrine inh 3 mg J9024 Inj atezolizumb 5mg hya-tqjs J9026 Inj, tarlatamab-dlle, 1 mg J9072 Inj cyclophos frindovyx 5 mg J9296 Inj pemetrexed (accord) 10mg J9323 Inj pemetrexed ditromethamin Q4123 Alloskin Q4143 Repriza, 1cm Q4161 Bio-connekt per square cm Q4164 Helicoll, per square cm Q4170 Cygnus, per sq cm Q4173 Palingen or palingen xplus Q4180 Revita, per sq cm Q4193 Coll-e-derm 1 sq cm Q4204 Xwrap 1 sq cm Q4221 Amniowrap2 per sq cm Q4227 Amniocore per sq cm Q4239 Amnio-maxx or lite per sq cm Q4248 Dermacyte amn mem allo sq cm Q4250 Amnioamp-mp per sq cm Q4263 Surgraft tl, per sq cm Q4264 Cocoon membrane, per sq cm Q4269 Surgraft xt per sq cm Q4270 Complete sl per sq cm Q4274 Esano ac, per sq cm Q4275 Esano aca, per sq cm Q4290 Membrane wrap hydr per sq cm Q4293 Acesso dl, per sq cm Q4294 Amnio quad-core, per sq cm Q4295 Amnio tri-core, per sq cm Q4296 Rebound matrix, per sq cm Q4299 Amnicore pro+, per sq cm Q4309 Via matrix, per sq cm Q4313 Dermabind fm, per sq cm Q4319 Sanograft, per sq cm Q4322 Caregraft, per sq cm Q4323 Alloply, per sq cm Q4325 Acapatch, per sq cm Q4328 Most, per sq cm Q4332 Axolotl dualgraft, per sq cm Q4343 Dermacyte ac matrx per sq cm Q5147 Inj, aflibercept-ayyh, 1 mg Deleted (7)
J0630 Calcitonin salmon injection J1300 Eculizumab injection J1748 Inj, zymfentra, 10 mg J1940 Furosemide injection J3357 Ustekinumab sub cu inj, 1 mg J9218 Leuprolide acetate injeciton Q3027 Inj beta interferon im 1 mcg January 2025 file +39 added · −23 deleted · 685 existing limits changed
Added (39)
J0282 Amiodarone hcl J0600 Edetate calcium disodium inj J0650 Inj, levothyroxine nos 10mcg J0651 Inj, levothyroxine, freskabi J0652 Inj, levothyroxine, hikma J0666 Inj, bupivacaine liposome J0739 Hiv prep, inj, cabotegravir J0750 Hiv prep, ftc/tdf 200/300mg J0751 Hiv prep, ftc/taf 200/25mg J0884 Argatroban esrd dialysis 1mg J1096 Dexametha opth insert 0.1 mg J1455 Foscarnet sodium injection J1552 Inj, alyglo, 500 mg J1573 Hepagam b intravenous, inj J1628 Inj., guselkumab, 1 mg J1741 Ibuprofen injection J1748 Inj, zymfentra, 10 mg J2425 Palifermin injection J2601 Inj, vasopressin (baxter) J2802 Inj, romiplostim 1 microgram J3470 Hyaluronidase injection J7516 Inj, cyclosporine 250mg J9028 Inj, nogapendekin pmln, 1mcg J9074 Inj, cyclophosphamd, sandoz J9172 Docetaxel (docivyx), 1 mg J9248 Inj melphalan (hepzato) 1 mg J9324 Inj, pemrydi rtu, 10 mg Q4138 Biodfence dryflex, 1cm Q4140 Biodfence 1cm Q4141 Alloskin ac, 1 cm Q4195 Puraply 1 sq cm Q4203 Derma-gide, 1 sq cm Q4231 Corplex p, per cc Q4289 Revoshield+ amnio, per sq cm Q4298 Amnicore pro, per sq cm Q5120 Inj pegfilgrastim-bmez 0.5mg Q5133 Inj, tofidence, 1 mg Q5135 Inj, tyenne, 1 mg Q9961 Hocm 250-299mg/ml iodine,1ml Deleted (23)
J2796 Romiplostim injection Q4143 Repriza, 1cm Q4147 Architect ecm px fx 1 sq cm Q4161 Bio-connekt per square cm Q4164 Helicoll, per square cm Q4170 Cygnus, per sq cm Q4173 Palingen or palingen xplus Q4180 Revita, per sq cm Q4193 Coll-e-derm 1 sq cm Q4204 Xwrap 1 sq cm Q4221 Amniowrap2 per sq cm Q4227 Amniocore per sq cm Q4239 Amnio-maxx or lite per sq cm Q4248 Dermacyte amn mem allo sq cm Q4263 Surgraft tl, per sq cm Q4268 Surgraft ft per sq cm Q4290 Membrane wrap hydr per sq cm Q4293 Acesso dl, per sq cm Q4294 Amnio quad-core, per sq cm Q4295 Amnio tri-core, per sq cm Q4296 Rebound matrix, per sq cm Q4299 Amnicore pro+, per sq cm Q4332 Axolotl dualgraft, per sq cm October 2024 file +25 added · −10 deleted · 686 existing limits changed
Added (25)
J0175 Inj, donanemab-azbt, 2 mg J0217 Inj velmanase alfa-tycv 1 mg J1171 Inj, hydromorphone, 0.1 mg J1598 Inj glycopyrrolate fres kabi J2002 Inj, lidocaine in d5w, 1 mg J2404 Inj, nicardipine 0.1 mg J2508 Pegunigalsidase alfa-iwxj J3425 Hydroxocobalamin im 10mcg J8522 Capecitabine, oral, 50 mg Q4158 Kerecis omega3, per sq cm Q4161 Bio-connekt per square cm Q4193 Coll-e-derm 1 sq cm Q4194 Novachor 1 sq cm Q4204 Xwrap 1 sq cm Q4225 Amnio or derma tl, per sq cm Q4279 Vendaje ac, per sq cm Q4290 Membrane wrap hydr per sq cm Q4293 Acesso dl, per sq cm Q4296 Rebound matrix, per sq cm Q4297 Emerge matrix, per sq cm Q4300 Acesso tl, per sq cm Q4301 Activate matrix, per sq cm Q4302 Complete aca, per sq cm Q4303 Complete aa, per sq cm Q4310 Procenta, per 100 mg Deleted (10)
J1170 Hydromorphone injection J2001 Lidocaine injection J8520 Capecitabine, oral, 150 mg J8521 Capecitabine, oral, 500 mg J9058 Inj apotex/bendamustine 1 mg J9059 Inj bendamustine, baxter 1mg J9259 Paclitaxel (american regent) J9323 Inj pemetrexed ditromethamin Q4141 Alloskin ac, 1 cm Q4298 Amnicore pro, per sq cm FAQ When do new J-codes get payment limits? A new code usually enters the quarterly file priced from WAC (typically WAC+3% in its first quarters) until enough manufacturer ASP data accumulates — then it transitions to ASP+6%, which is why young codes often show violent early limit moves. Biosimilars typically launch on temporary Q-codes.
What does it mean when a code disappears from the file? Deletion from the payment-limit file usually follows a HCPCS recode (a temporary Q-code graduating to a permanent J-code, or a code split), discontinuation, or a benefit-category change. A claim billed on a deleted code denies — the quarterly HCPCS update file documents the crosswalk to the successor code.
Why do these adds matter for margin? New codes are where pricing is least efficient: WAC-based limits, no contract history, and payer systems that lag the fee schedule. The first quarters of a new code are simultaneously the best chance to capture spread and the highest denial risk — worth a deliberate decision rather than a default.
Coding details for any new drug — units, modifiers, payer policy — live on CareCost Estimate’s billing references . Pricing history per drug: drug trend pages .
Drug economics as of Q3 2026 (Medicare ASP basis)
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