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HCPCS J3260 · Level II · Part B drug

HCPCS J3260: Injection, tobramycin sulfate, up to 80 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 J3260

Billing unit
80 MG
Tobramycin sulfate injection
ASP payment limit
$2.345
October 2026; +7.3% vs July 2026
Practitioner MUE
8
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J3260 is the Level II code for Injection, tobramycin sulfate, up to 80 mg, billed per 80 MG. The Medicare Part B ASP payment limit for October 2026 is $2.345 per billing unit, up 7.3% from July 2026. The practitioner MUE allows up to 8 units per date of service (MAI 3). Under OPPS it carries status indicator N. J3260 is billed in units of 80 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 19 NDCs to it, sold as Tobramycin Sulfate, Tobramycin by Pfizer Inc, Baxter Healthcare Corporation, XGen Pharmaceuticals DJB, Inc.. No current Billing and Coding Article lists J3260, 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 J3260 at $2.345 per 80 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $2.186 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J3260
QuarterPayment limitPerCoinsurance
October 2026$2.34580 MG20%
July 2026$2.18680 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 19 NDCs from 10 labelers to J3260. Report the NDC in the claim's drug segment and bill the number of J3260 units that equals the quantity administered divided by 80 MG; the last column gives units per full package.

NDCs that crosswalk to J3260
NDCDrug nameLabelerPackage sizeBilling units / package
00409-3578-01Tobramycin SulfatePfizer Inc2 × 2525
36000-0242-01Tobramycin SulfateBaxter Healthcare Corporation1 × 115
36000-0244-25Tobramycin SulfateBaxter Healthcare Corporation2 × 2525
39822-0412-01Tobramycin SulfateXGen Pharmaceuticals DJB, Inc.1 × 115
39822-0412-06Tobramycin SulfateXGen Pharmaceuticals DJB, Inc.1 × 690
55150-0470-06Tobramycin SulfateEugia US LLC1 × 690
63323-0303-51Tobramycin SulfateFreseniUS Kabi USA, LLC1 × 690
63323-0303-55Tobramycin SulfateFreseniUS Kabi USA, LLC1 × 690
63323-0305-02Tobramycin SulfateFreseniUS Kabi USA, LLC2 × 257
63323-0306-02Tobramycin SulfateFreseniUS Kabi USA, LLC2 × 2525
63323-0306-30Tobramycin SulfateFreseniUS Kabi USA, LLC30 × 10150
67457-0428-30Tobramycin SulfateMylan Institutional LLC30 × 10150
67457-0473-22Tobramycin SulfateMylan Institutional LLC2 × 2525
70436-0110-56Tobramycin SulfateSlate Run Pharmaceuticals1 × 690
70436-0110-80Tobramycin SulfateSlate Run Pharmaceuticals1 × 115
70700-0173-22TobramycinXiromed, LLC1 × 115
70700-0173-86Tobramycin SulfateXiromed, LLC1 × 690
72266-0163-06Tobramycin SulfateFosun Pharma USA Inc.1 × 690
72603-0160-06Tobramycin SulfateNorthstar RxLLC1 × 690

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J3260. For practitioners the limit is 8 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 J3260 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services83 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital123 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J3260 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.

J3260 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 J3260 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, J3260 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J3260 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 J3260 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 J3260

What does HCPCS code J3260 describe?

J3260 is defined by CMS as "Injection, tobramycin sulfate, up to 80 mg". Each billing unit represents 80 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J3260 in October 2026?

The ASP-based payment limit is $2.345 per 80 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $2.186.

How many units of J3260 can be billed per day?

The practitioner Medically Unlikely Edit is 8 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 "Clinical: Data" as the rationale.

Which NDCs map to J3260?

The October 2026 ASP crosswalk lists 19 NDCs from 10 labelers: Tobramycin Sulfate (Pfizer Inc); Tobramycin Sulfate (Baxter Healthcare Corporation); Tobramycin Sulfate (XGen Pharmaceuticals DJB, Inc.); Tobramycin Sulfate (Eugia US LLC). For example NDC 00409-3578-01 is a 2 package equal to 25 billing units. The crosswalk's billing-units-per-package figure converts each package into J3260 units.

Does J3260 have NCCI bundling edits?

No active practitioner PTP pairs list J3260 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.