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HCPCS J0887 · Level II · Part B drug

HCPCS J0887: Injection, epoetin beta, 1 microgram, (for esrd on dialysis)

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 J0887

Billing unit
1 MCG
Epoetin beta esrd use
ASP payment limit
$1.196
October 2026; +9.7% vs July 2026
Practitioner MUE
360
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
4 states

TL;DR

HCPCS J0887 is the Level II code for Injection, epoetin beta, 1 microgram, (for esrd on dialysis), billed per 1 MCG. The Medicare Part B ASP payment limit for October 2026 is $1.196 per billing unit, up 9.7% from July 2026. The practitioner MUE allows up to 360 units per date of service (MAI 3). Under OPPS it carries status indicator N. Because the descriptor is specific to ESRD patients on dialysis, Medicare expects the drug inside the ESRD prospective payment bundle when furnished by the dialysis facility, and separate Part B billing applies only outside that setting. The ASP crosswalk maps 7 NDCs to it, sold as Mircera by Vifor (International) Inc.. 1 Medicare coverage article lists the code across 4 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J0887 at $1.196 per 1 MCG for October 2026, derived from manufacturer average sales price plus 6%, compared with $1.09 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J0887
QuarterPayment limitPerCoinsurance
October 2026$1.1961 MCG20%
July 2026$1.091 MCG—
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 7 NDCs from 1 labeler to J0887. Report the NDC in the claim's drug segment and bill the number of J0887 units that equals the quantity administered divided by 1 MCG; the last column gives units per full package.

NDCs that crosswalk to J0887
NDCDrug nameLabelerPackage sizeBilling units / package
59353-0400-09MirceraVifor (International) Inc.0.3 × 130
59353-0401-09MirceraVifor (International) Inc.0.3 × 150
59353-0402-09MirceraVifor (International) Inc.0.3 × 175
59353-0403-09MirceraVifor (International) Inc.0.3 × 1100
59353-0404-09MirceraVifor (International) Inc.0.3 × 1150
59353-0405-09MirceraVifor (International) Inc.0.3 × 1200
59353-0407-09MirceraVifor (International) Inc.0.3 × 1120

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J0887. For practitioners the limit is 360 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 J0887 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services3603 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital3603 Date of Service Edit: ClinicalPrescribing Information
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0887 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.

J0887 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J0887 in their HCPCS tables, covering 4 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J0887
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)Wisconsin Physicians Service Insurance CorporationIA KS MO NEL34633, L38446

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J0887 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J0887 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 J0887 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.

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Frequently asked questions — HCPCS J0887

What does HCPCS code J0887 describe?

J0887 is defined by CMS as "Injection, epoetin beta, 1 microgram, (for esrd on dialysis)". Each billing unit represents 1 MCG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0887 in October 2026?

The ASP-based payment limit is $1.196 per 1 MCG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $1.09.

How many units of J0887 can be billed per day?

The practitioner Medically Unlikely Edit is 360 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 J0887?

The October 2026 ASP crosswalk lists 7 NDCs from 1 labeler: Mircera (Vifor (International) Inc.). For example NDC 59353-0400-09 is a 0.3 package equal to 30 billing units. The crosswalk's billing-units-per-package figure converts each package into J0887 units.

Does J0887 have NCCI bundling edits?

No active practitioner PTP pairs list J0887 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J0887?

1 current Billing and Coding Article in the Medicare Coverage Database list J0887, covering 4 states: (Billing and Coding: Erythropoiesis Stimulating Agents (ESAs)).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. 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.