Skip to main content
HCPCS J0736 · Level II · Part B drug

HCPCS J0736: Injection, clindamycin phosphate, 300 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 J0736

Billing unit
300 MG
Inj, clindamycin phosp 300mg
ASP payment limit
$1.854
October 2026; -6.1% vs July 2026
Practitioner MUE
9
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J0736 is the Level II code for Injection, clindamycin phosphate, 300 mg, billed per 300 MG. The Medicare Part B ASP payment limit for October 2026 is $1.854 per billing unit, down 6.1% from July 2026. The practitioner MUE allows up to 9 units per date of service (MAI 3). Under OPPS it carries status indicator N. J0736 is billed in units of 300 MG; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 27 NDCs to it, sold as Cleocin, Clindamycin Phosphate by Pfizer Inc, Hikma Pharmaceuticals USA Inc., Baxter Healthcare Corporation. No current Billing and Coding Article lists J0736, 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 J0736 at $1.854 per 300 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $1.974 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J0736
QuarterPayment limitPerCoinsurance
October 2026$1.854300 MG20%
July 2026$1.974300 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 27 NDCs from 7 labelers to J0736. Report the NDC in the claim's drug segment and bill the number of J0736 units that equals the quantity administered divided by 300 MG; the last column gives units per full package.

NDCs that crosswalk to J0736
NDCDrug nameLabelerPackage sizeBilling units / package
00009-0728-09CleocinPfizer Inc60 × 5150
00009-0775-26CleocinPfizer Inc4 × 2550
00009-0870-26CleocinPfizer Inc2 × 2525
00009-0902-18CleocinPfizer Inc6 × 2575
00009-3051-02CleocinPfizer Inc2 × 2525
00009-4073-04CleocinPfizer Inc4 × 2550
00009-5095-06CleocinPfizer Inc6 × 2575
00143-9267-01Clindamycin PhosphateHikma Pharmaceuticals USA Inc.50 × 11
00143-9268-01Clindamycin PhosphateHikma Pharmaceuticals USA Inc.50 × 12
00143-9269-01Clindamycin PhosphateHikma Pharmaceuticals USA Inc.50 × 13
00338-3410-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2424
00338-3612-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2448
00338-3616-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2448
00338-3814-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2472
00338-4114-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2472
00404-9837-02CleocinHenry Schein Inc.2 × 11
00404-9838-04Clindamycin PhosphateHenry Schein Inc.4 × 12
00781-3288-09Clindamycin PhosphateSandoz Inc.50 × 2424
00781-3289-09Clindamycin PhosphateSandoz Inc.50 × 2448
00781-3290-09Clindamycin PhosphateSandoz Inc.50 × 2472
25021-0115-02Clindamycin PhosphateSagent Pharmaceuticals2 × 2525
25021-0115-04Clindamycin PhosphateSagent Pharmaceuticals4 × 2550
25021-0115-06Clindamycin PhosphateSagent Pharmaceuticals6 × 2575
43066-0993-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2448
43066-0995-24Clindamycin PhosphateBaxter Healthcare Corporation50 × 2472
72572-0074-24Clindamycin PhosphateCivica, Inc.50 × 2448
72572-0076-24Clindamycin PhosphateCivica, Inc.50 × 2472

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for J0736. For practitioners the limit is 9 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 J0736 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services93 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital93 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0736 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.

J0736 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 J0736 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, J0736 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J0736 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 J0736 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 J0736

What does HCPCS code J0736 describe?

J0736 is defined by CMS as "Injection, clindamycin phosphate, 300 mg". Each billing unit represents 300 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0736 in October 2026?

The ASP-based payment limit is $1.854 per 300 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $1.974.

How many units of J0736 can be billed per day?

The practitioner Medically Unlikely Edit is 9 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 "Prescribing Information" as the rationale.

Which NDCs map to J0736?

The October 2026 ASP crosswalk lists 27 NDCs from 7 labelers: Cleocin (Pfizer Inc); Clindamycin Phosphate (Hikma Pharmaceuticals USA Inc.); Clindamycin Phosphate (Baxter Healthcare Corporation); Cleocin (Henry Schein Inc.). For example NDC 00009-0728-09 is a 60 package equal to 150 billing units. The crosswalk's billing-units-per-package figure converts each package into J0736 units.

Does J0736 have NCCI bundling edits?

No active practitioner PTP pairs list J0736 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.