ASP Drug Pricing - (2nd Quarter)
April 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Oct 2025 (4th Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate Medicare coverage of the drug. Similarly, the inclusion of a payment allowance limit within a specific column does not indicate Medicare coverage of the drug in that specific category. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 27 * Effective April 1, 2026 through June 30, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J9076 - Injection, cyclophosphamide (baxter), 5 mg 5 MG 3.724 - - - - - -
J9100 - Injection, cytarabine, 100 mg 100 MG 0.799 - - - - - -
J9118 - Injection, calaspargase pegol-mknl, 10 units 10 UNIT 82.075 - - - - - -
J9119 - Injection, cemiplimab-rwlc, 1 mg 1 MG 29.762 - - - - - -
J9120 - Injection, dactinomycin, 0.5 mg 0.5 MG 337.669 - - - - - -
J9130 - Dacarbazine, 100 mg 100 MG 3.852 - - - - - -
J9144 - Injection, daratumumab, 10 mg and hyaluronidase-fihj 10 MG 55.032 - - - - - -
J9145 - Injection, daratumumab, 10 mg 10 MG 70.774 - - - - - -
J9150 - Injection, daunorubicin, 10 mg 10 MG 24.748 - - - - - -
J9153 - Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine 1 MG/2.27 MG 261.195 - - - - - -
J9155 - Injection, degarelix, 1 mg 1 MG 4.458 - - - - - -
J9171 - Injection, docetaxel, 1 mg 1 MG 0.556 - - - - - -
J9172 - Injection, docetaxel (docivyx), 1 mg 1 MG 50.607 - - - - - -
J9173 - Injection, durvalumab, 10 mg 10 MG 86.146 - - - - - -
J9176 - Injection, elotuzumab, 1 mg 1 MG 8.041 - - - - - -
J9177 - Injection, enfortumab vedotin-ejfv, 0.25 mg 0.25 MG 36.707 - - - - - -
J9178 - Injection, epirubicin hcl, 2 mg 2 MG 1.767 - - - - - -
J9179 - Injection, eribulin mesylate, 0.1 mg 0.1 MG 76.756 - - - - - -
J9181 - Injection, etoposide, 10 mg 10 MG 0.9 - - - - - -
J9183 - Gemcitabine intravesical system, 225 mg 225 MG 73088.26 - - - - - -
J9184 - Injection, gemcitabine hydrochloride (avyxa), 200 mg 200 MG 410.439 - - - - - -
J9185 - Injection, fludarabine phosphate, 50 mg 50 MG 217.726 - - - - - -
J9190 - Injection, fluorouracil, 500 mg 500 MG 2.056 - - - - - -
J9196 - Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg 200 MG 5.29 - - - - - -
J9200 - Injection, floxuridine, 500 mg 500 MG 4250.967 - - - - - -
* Effective April 1, 2026 through June 30, 2026

ASP (Average Sale Price) Drug Pricing History