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 27 * 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
J9026 - Injection, tarlatamab-dlle, 1 mg 1 MG 1566.586 - - - - - -
J9027 - Injection, clofarabine, 1 mg 1 MG 14.369 - - - - - -
J9028 - Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram 1 MCG 94.728 - - - - - -
J9029 - Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose PER THERAPEUTIC DOSE 64274.791 - - - - - -
J9030 - Bcg live intravesical instillation, 1 mg 1 MG 3.279 - - - - - -
J9032 - Injection, belinostat, 10 mg 10 MG 53.111 - - - - - -
J9033 - Injection, bendamustine hydrochloride, 1 mg 1 MG 2.047 - - - - - -
J9034 - Injection, bendamustine hcl (bendeka), 1 mg 1 MG 12.834 - - - - - -
J9035 - Injection, bevacizumab, 10 mg 10 MG 73.632 - - - - - -
J9036 - Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg 1 MG 13.649 - - - - - -
J9038 - Injection, axatilimab-csfr, 0.1 mg 0.1 MG 55.650 - - - - - -
J9039 - Injection, blinatumomab, 1 microgram 1 MCG 163.683 - - - - - -
J9040 - Injection, bleomycin sulfate, 15 units 15 UNITS 23.018 - - - - - -
J9041 - Injection, bortezomib, 0.1 mg 0.1 MG 2.678 - - - - - -
J9042 - Injection, brentuximab vedotin, 1 mg 1 MG 268.451 - - - - - -
J9043 - Injection, cabazitaxel, 1 mg 1 MG 230.796 - - - - - -
J9045 - Injection, carboplatin, 50 mg 50 MG 2.929 - - - - - -
J9047 - Injection, carfilzomib, 1 mg 1 MG 55.607 - - - - - -
J9049 - Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg 0.1 MG 1.454 - - - - - -
J9050 - Injection, carmustine, 100 mg 100 MG 232.623 - - - - - -
J9054 - Injection, bortezomib (boruzu), 0.1 mg 0.1 MG 25.634 - - - - - -
J9055 - Injection, cetuximab, 10 mg 10 MG 80.343 - - - - - -
J9056 - Injection, bendamustine hydrochloride (vivimusta), 1 mg 1 MG 31.993 - - - - - -
J9060 - Injection, cisplatin, powder or solution, 10 mg 10 MG 2.112 - - - - - -
J9061 - Injection, amivantamab-vmjw, 2 mg 2 MG 22.555 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History