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HCPCS J1650 · Level II · Part B drug

HCPCS J1650: Injection, enoxaparin sodium, 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 J1650

Billing unit
10 MG
Inj enoxaparin sodium
ASP payment limit
$0.497
October 2026; -7.3% vs July 2026
Practitioner MUE
30
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J1650 is the Level II code for Injection, enoxaparin sodium, 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $0.497 per billing unit, down 7.3% from July 2026. The practitioner MUE allows up to 30 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 144 NDCs to it, sold as Lovenox, Enoxaparin Sodium by Sanofi-Aventis U.S. LLC, Amphastar Pharmaceuticals, Inc., Sandoz Inc.. No current Billing and Coding Article lists J1650, 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 J1650 at $0.497 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.536 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J1650
QuarterPayment limitPerCoinsurance
October 2026$0.49710 MG20%
July 2026$0.53610 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 144 NDCs from 13 labelers to J1650. Report the NDC in the claim's drug segment and bill the number of J1650 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J1650
NDCDrug nameLabelerPackage sizeBilling units / package
00075-0620-40LovenoxSanofi-Aventis U.S. LLC0.4 × 1040
00075-0621-60LovenoxSanofi-Aventis U.S. LLC0.6 × 1060
00075-0622-80LovenoxSanofi-Aventis U.S. LLC0.8 × 1080
00075-0623-00LovenoxSanofi-Aventis U.S. LLC1 × 10100
00075-0624-30LovenoxSanofi-Aventis U.S. LLC0.3 × 1030
00075-0626-03LovenoxSanofi-Aventis U.S. LLC3 × 130
00075-2912-01LovenoxSanofi-Aventis U.S. LLC0.8 × 10120
00075-2915-01LovenoxSanofi-Aventis U.S. LLC1 × 10150
00075-8013-10LovenoxSanofi-Aventis U.S. LLC0.3 × 1030
00075-8014-10LovenoxSanofi-Aventis U.S. LLC0.4 × 1040
00075-8016-10LovenoxSanofi-Aventis U.S. LLC0.6 × 1060
00075-8018-10LovenoxSanofi-Aventis U.S. LLC0.8 × 1080
00075-8020-10LovenoxSanofi-Aventis U.S. LLC1 × 10100
00075-8022-10LovenoxSanofi-Aventis U.S. LLC0.8 × 10120
00075-8025-10LovenoxSanofi-Aventis U.S. LLC1 × 10150
00075-8030-01LovenoxSanofi-Aventis U.S. LLC3 × 130
00548-5601-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.0.3 × 1030
00548-5602-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.0.4 × 1040
00548-5603-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.0.6 × 1060
00548-5604-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.0.8 × 1080
00548-5605-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.1 × 10100
00548-5606-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.0.8 × 10120
00548-5607-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.1 × 10150
00548-5608-00Enoxaparin SodiumAmphastar Pharmaceuticals, Inc.3 × 130
00781-3238-63Enoxaparin SodiumSandoz Inc.0.3 × 1030
00781-3246-64Enoxaparin SodiumSandoz Inc.0.4 × 1040
00781-3256-66Enoxaparin SodiumSandoz Inc.0.6 × 1060
00781-3262-68Enoxaparin SodiumSandoz Inc.0.8 × 1080
00781-3268-69Enoxaparin SodiumSandoz Inc.1 × 10100
00781-3298-68Enoxaparin SodiumSandoz Inc.0.8 × 10120
00781-3299-69Enoxaparin SodiumSandoz Inc.1 × 10150
00955-1003-10Enoxaparin SodiumSanofi-Aventis U.S. LLC0.3 × 1030
00955-1004-10Enoxaparin SodiumSanofi-Aventis U.S. LLC0.4 × 1040
00955-1006-10Enoxaparin SodiumSanofi-Aventis U.S. LLC0.6 × 1060
00955-1008-10Enoxaparin SodiumSanofi-Aventis U.S. LLC0.8 × 1080
00955-1010-10Enoxaparin SodiumSanofi-Aventis U.S. LLC1 × 10100
00955-1012-10Enoxaparin SodiumSanofi-Aventis U.S. LLC0.8 × 10120
00955-1015-10Enoxaparin SodiumSanofi-Aventis U.S. LLC1 × 10150
00955-1016-01Enoxaparin SodiumSanofi-Aventis U.S. LLC3 × 130
16714-0006-10Enoxaparin SodiumNorthstar RxLLC0.3 × 1030
16714-0016-10Enoxaparin SodiumNorthstar RxLLC0.4 × 1040
16714-0026-10Enoxaparin SodiumNorthstar RxLLC0.6 × 1060
16714-0036-10Enoxaparin SodiumNorthstar RxLLC0.8 × 1080
16714-0046-10Enoxaparin SodiumNorthstar RxLLC1 × 10100
16714-0056-10Enoxaparin SodiumNorthstar RxLLC0.8 × 10120
16714-0066-10Enoxaparin SodiumNorthstar RxLLC1 × 10150
25021-0410-70Enoxaparin SodiumSagent Pharmaceuticals0.3 × 1030
25021-0410-71Enoxaparin SodiumSagent Pharmaceuticals1 × 10100
25021-0410-76Enoxaparin SodiumSagent Pharmaceuticals0.4 × 1040
25021-0410-77Enoxaparin SodiumSagent Pharmaceuticals0.6 × 1060
25021-0410-78Enoxaparin SodiumSagent Pharmaceuticals0.8 × 1080
25021-0411-70Enoxaparin SodiumSagent Pharmaceuticals0.8 × 10120
25021-0411-71Enoxaparin SodiumSagent Pharmaceuticals1 × 10150
60505-0792-04Enoxaparin SodiumApotex Corp0.4 × 1040
60505-0794-04Enoxaparin SodiumApotex Corp0.8 × 1080
60505-0795-04Enoxaparin SodiumApotex Corp1 × 10100
60505-0796-04Enoxaparin SodiumApotex Corp0.8 × 10120
60505-0798-04Enoxaparin SodiumApotex Corp1 × 10150
63323-0531-90Enoxaparin SodiumFreseniUS Kabi USA, LLC0.8 × 1080
63323-0531-98Enoxaparin SodiumFreseniUS Kabi USA, LLC0.8 × 1080
Showing 60 of 144 NDCs.

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J1650. For practitioners the limit is 30 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 J1650 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services303 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital303 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 J1650 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.

J1650 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 J1650 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, J1650 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J1650 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 J1650 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 J1650

What does HCPCS code J1650 describe?

J1650 is defined by CMS as "Injection, enoxaparin sodium, 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 J1650 in October 2026?

The ASP-based payment limit is $0.497 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 $0.536.

How many units of J1650 can be billed per day?

The practitioner Medically Unlikely Edit is 30 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 J1650?

The October 2026 ASP crosswalk lists 144 NDCs from 13 labelers: Lovenox (Sanofi-Aventis U.S. LLC); Enoxaparin Sodium (Amphastar Pharmaceuticals, Inc.); Enoxaparin Sodium (Sandoz Inc.); Enoxaparin Sodium (Sanofi-Aventis U.S. LLC). For example NDC 00075-0620-40 is a 0.4 package equal to 40 billing units. The crosswalk's billing-units-per-package figure converts each package into J1650 units.

Does J1650 have NCCI bundling edits?

No active practitioner PTP pairs list J1650 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.