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HCPCS J0612 · Level II · Part B drug

HCPCS J0612: Injection, calcium gluconate, not otherwise specified, 10 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J0612

Billing unit
10 MG
Inj, calcium gluconate, nos
ASP payment limit
$0.024
October 2026; -11.1% vs July 2026
Practitioner MUE
800
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J0612 is the Level II code for Injection, calcium gluconate, not otherwise specified, 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $0.024 per billing unit, down 11.1% from July 2026. The practitioner MUE allows up to 800 units per date of service (MAI 3). Under OPPS it carries status indicator N. The 10 mg billing unit means doses are reported in multiples of ten milligrams, with any remainder rounded per contractor policy; mismatched units against the NDC quantity trigger MUE and NDC-unit edits. The ASP crosswalk maps 24 NDCs to it, sold as Calcium Gluconate by Hikma Pharmaceuticals USA Inc., Henry Schein Inc., HF Acquisition Co. LLC, DBA HealthFirst. No current Billing and Coding Article lists J0612, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J0612 at $0.024 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.027 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J0612
QuarterPayment limitPerCoinsurance
October 2026$0.02410 MG20%
July 2026$0.02710 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 24 NDCs from 8 labelers to J0612. Report the NDC in the claim's drug segment and bill the number of J0612 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J0612
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9180-25Calcium GluconateHikma Pharmaceuticals USA Inc.10 × 252500
00143-9184-25Calcium GluconateHikma Pharmaceuticals USA Inc.50 × 2512500
00143-9185-20Calcium GluconateHikma Pharmaceuticals USA Inc.100 × 2020000
00404-9764-10Calcium GluconateHenry Schein Inc.10 × 1100
00404-9831-10Calcium GluconateHenry Schein Inc.10 × 1100
00404-9831-50Calcium GluconateHenry Schein Inc.50 × 1500
51662-1312-01Calcium GluconateHF Acquisition Co. LLC, DBA HealthFirst10 × 1100
63323-0360-19Calcium GluconateFreseniUS Kabi USA, LLC10 × 252500
63323-0360-59Calcium GluconateFreseniUS Kabi USA, LLC50 × 2512500
63323-0360-61Calcium GluconateFreseniUS Kabi USA, LLC100 × 2020000
65219-0162-10Calcium GluconateFreseniUS Kabi USA, LLC50 × 242400
65219-0164-50Calcium GluconateFreseniUS Kabi USA, LLC100 × 244800
65219-0630-19Calcium GluconateFreseniUS Kabi USA, LLC10 × 252500
70069-0727-10Calcium GluconateSomerset Pharma, LLC50 × 105000
70069-0727-25Calcium GluconateSomerset Pharma, LLC50 × 2512500
70069-0728-20Calcium GluconateSomerset Pharma, LLC100 × 2020000
75834-0171-19Calcium GluconateNivagen Pharmaceuticals, Inc.10 × 252500
80830-1672-02Calcium GluconateAmneal Pharmaceuticals, LLC10 × 101000
80830-1673-02Calcium GluconateAmneal Pharmaceuticals, LLC50 × 105000
80830-1674-02Calcium GluconateAmneal Pharmaceuticals, LLC100 × 1010000
80830-2362-02Calcium GluconateAmneal Pharmaceuticals, LLC50 × 121200
80830-2362-09Calcium GluconateAmneal Pharmaceuticals Private Limited50 × 242400
80830-2363-02Calcium GluconateAmneal Pharmaceuticals, LLC100 × 122400
80830-2363-09Calcium GluconateAmneal Pharmaceuticals Private Limited100 × 244800

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for J0612. For practitioners the limit is 800 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J0612 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services8003 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital8003 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0612 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J0612 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J0612 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J0612 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J0612 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J0612 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J0612

What does HCPCS code J0612 describe?

J0612 is defined by CMS as "Injection, calcium gluconate, not otherwise specified, 10 mg". Each billing unit represents 10 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0612 in October 2026?

The ASP-based payment limit is $0.024 per 10 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.027.

How many units of J0612 can be billed per day?

The practitioner Medically Unlikely Edit is 800 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "CMS Policy" as the rationale.

Which NDCs map to J0612?

The October 2026 ASP crosswalk lists 24 NDCs from 8 labelers: Calcium Gluconate (Hikma Pharmaceuticals USA Inc.); Calcium Gluconate (Henry Schein Inc.); Calcium Gluconate (HF Acquisition Co. LLC, DBA HealthFirst); Calcium Gluconate (FreseniUS Kabi USA, LLC). For example NDC 00143-9180-25 is a 10 package equal to 2500 billing units. The crosswalk's billing-units-per-package figure converts each package into J0612 units.

Does J0612 have NCCI bundling edits?

No active practitioner PTP pairs list J0612 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.