ASP Drug Pricing - (3rd Quarter)
July 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jan 2026 (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 27 * Effective Jul 1, 2026 through Sep 30, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J9074 - Injection, cyclophosphamide (sandoz), 5 mg 5 MG 3.438 - - - - - -
J9075 - Injection, cyclophosphamide, not otherwise specified, 5 mg 5 MG 0.575 - - - - - -
J9076 - Injection, cyclophosphamide (baxter), 5 mg 5 MG 4.387 - - - - - -
J9100 - Injection, cytarabine, 100 mg 100 MG 0.853 - - - - - -
J9118 - Injection, calaspargase pegol-mknl, 10 units 10 UNIT 85.789 - - - - - -
J9119 - Injection, cemiplimab-rwlc, 1 mg 1 MG 29.668 - - - - - -
J9120 - Injection, dactinomycin, 0.5 mg 0.5 MG 307.411 - - - - - -
J9130 - Dacarbazine, 100 mg 100 MG 3.463 - - - - - -
J9144 - Injection, daratumumab, 10 mg and hyaluronidase-fihj 10 MG 57.051 - - - - - -
J9145 - Injection, daratumumab, 10 mg 10 MG 73.77 - - - - - -
J9150 - Injection, daunorubicin, 10 mg 10 MG 28.81 - - - - - -
J9153 - Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine 1 MG/2.27 MG 272.886 - - - - - -
J9155 - Injection, degarelix, 1 mg 1 MG 4.481 - - - - - -
J9161 - Injection, denileukin diftitox-cxdl, 1 mcg 1 MCG 12.826 - - - - - -
J9171 - Injection, docetaxel, 1 mg 1 MG 0.456 - - - - - -
J9172 - Injection, docetaxel (docivyx), 1 mg 1 MG 46.287 - - - - - -
J9173 - Injection, durvalumab, 10 mg 10 MG 87.95 - - - - - -
J9174 - Injection, docetaxel (beizray), 1 mg 1 MG 46.808 - - - - - -
J9176 - Injection, elotuzumab, 1 mg 1 MG 8.189 - - - - - -
J9177 - Injection, enfortumab vedotin-ejfv, 0.25 mg 0.25 MG 36.658 - - - - - -
J9178 - Injection, epirubicin hcl, 2 mg 2 MG 1.994 - - - - - -
J9179 - Injection, eribulin mesylate, 0.1 mg 0.1 MG 59.979 - - - - - -
J9181 - Injection, etoposide, 10 mg 10 MG 1.018 - - - - - -
J9183 - Gemcitabine intravesical system, 225 mg 225 MG 72984.241 - - - - - -
J9184 - Injection, gemcitabine hydrochloride (avyxa), 200 mg 200 MG 400.334 - - - - - -
* Effective Jul 1, 2026 through Sep 30, 2026

ASP (Average Sale Price) Drug Pricing History