ASP Drug Pricing - (3rd Quarter)
July 2025
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jan 2025 (1st 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 16 * Effective Jul 1, 2025 through Sep 30, 2025
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J2598 - Injection, vasopressin, 1 unit 1 UNIT 1.255 - - - - - -
J2599 - Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit 1 UNIT 0.475 - - - - - -
J2601 - Injection, vasopressin (baxter), 1 unit 1 UNIT 2.936 - - - - - -
J2675 - Injection, progesterone, per 50 mg 50 MG 0.626 - - - - - -
J2679 - Injection, fluphenazine hcl, 1.25 mg 1.25 MG 7.427 - - - - - -
J2680 - Injection, fluphenazine decanoate, up to 25 mg 25 MG 7.532 - - - - - -
J2690 - Injection, procainamide hcl, up to 1 gm 1 GM 194.316 - - - - - -
J2700 - Injection, oxacillin sodium, up to 250 mg 250 MG 0.822 - - - - - -
J2704 - Injection, propofol, 10 mg 10 MG 0.09 - - - - - -
J2720 - Injection, protamine sulfate, per 10 mg 10 MG 1.637 - - - - - -
J2724 - Injection, protein c concentrate, intravenous, human, 10 iu 10 UNITS 1.503 - - - - - -
J2760 - Injection, phentolamine mesylate, up to 5 mg 5 MG 436.507 - - - - - -
J2765 - Injection, metoclopramide hcl, up to 10 mg 10 MG 0.997 - - - - - -
J2777 - Injection, faricimab-svoa, 0.1 mg 0.1 MG 34.478 - - - - - -
J2778 - Injection, ranibizumab, 0.1 mg 0.1 mg 91.112 - - - - - -
J2779 - Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg 0.1 MG 78.431 - - - - - -
J2781 - Injection, pegcetacoplan, intravitreal, 1 mg 1 MG 141.91 - - - - - -
J2782 - Injection, avacincaptad pegol, 0.1 mg 0.1 MG 105.896 - - - - - -
J2783 - Injection, rasburicase, 0.5 mg 0.5 MG 376.48 - - - - - -
J2785 - Injection, regadenoson, 0.1 mg 0.1 MG 2.892 - - - - - -
J2786 - Injection, reslizumab, 1 mg 1 MG 10.575 - - - - - -
J2788 - Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) 50 MCG (250 IU) 27.859 - - - - - -
J2790 - Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) 300 MCG (1500 IU) 82.423 - - - - - -
J2791 - Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu 100 IU 4.967 - - - - - -
J2792 - Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu 100 IU 30.772 - - - - - -
* Effective Jul 1, 2025 through Sep 30, 2025

Drugs not otherwise classified - July 2025

 

Medicare Part B payment allowance limits for drugs not otherwise classified - Effective Jul 1, 2025 through Sep 30, 2025

Drug name Dosage Payment limit Notes
Vasopressin (Long Grove) 1 UNIT 2.796

ASP (Average Sale Price) Drug Pricing History