ASP Drug Pricing - (1st Quarter)
January 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jul 2025 (3nd Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate whether Medicare covers a drug. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 18 * Effective January 1, 2026 through March 31, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J2601 - Injection, vasopressin (baxter), 1 unit 1 UNIT 2.222 - - - - - -
J2675 - Injection, progesterone, per 50 mg 50 MG 0.716 - - - - - -
J2679 - Injection, fluphenazine hcl, 1.25 mg 1.25 MG 7.391 - - - - - -
J2680 - Injection, fluphenazine decanoate, up to 25 mg 25 MG 6.198 - - - - - -
J2690 - Injection, procainamide hcl, up to 1 gm 1 GM 344.530 - - - - - -
J2700 - Injection, oxacillin sodium, up to 250 mg 250 MG 0.569 - - - - - -
J2704 - Injection, propofol, 10 mg 10 MG 0.089 - - - - - -
J2720 - Injection, protamine sulfate, per 10 mg 10 MG 1.571 - - - - - -
J2724 - Injection, protein c concentrate, intravenous, human, 10 iu 10 UNITS 15.014 - - - - - -
J2760 - Injection, phentolamine mesylate, up to 5 mg 5 MG 420.558 - - - - - -
J2765 - Injection, metoclopramide hcl, up to 10 mg 10 MG 1.083 - - - - - -
J2777 - Injection, faricimab-svoa, 0.1 mg 0.1 MG 32.898 - - - - - -
J2778 - Injection, ranibizumab, 0.1 mg 0.1 mg 65.443 - - - - - -
J2779 - Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg 0.1 MG 76.223 - - - - - -
J2781 - Injection, pegcetacoplan, intravitreal, 1 mg 1 MG 138.049 - - - - - -
J2782 - Injection, avacincaptad pegol, 0.1 mg 0.1 MG 102.917 - - - - - -
J2783 - Injection, rasburicase, 0.5 mg 0.5 MG 383.372 - - - - - -
J2785 - Injection, regadenoson, 0.1 mg 0.1 MG 2.679 - - - - - -
J2786 - Injection, reslizumab, 1 mg 1 MG 11.134 - - - - - -
J2788 - Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) 50 MCG (250 IU) 22.931 - - - - - -
J2790 - Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 300 MCG (1500 IU) 80.532 - - - - - -
J2791 - Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu 100 IU 4.829 - - - - - -
J2792 - Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu 100 IU 33.910 - - - - - -
J2794 - Injection, risperidone (risperdal consta), 0.5 mg 0.5 MG 11.184 - - - - - -
J2795 - Injection, ropivacaine hydrochloride, 1 mg 1 MG 0.050 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History