Key facts for J3373
- Billing unit
- 10 MG
- Inj, vancomycin hcl, 10 mg
- ASP payment limit
- $0.032
- October 2026; -3.0% vs July 2026
- Practitioner MUE
- 600
- MAI 3
- OPPS status
- SI N
- NCCI exposure
- no PTP pairs
- Coverage articles
- 0
- none list this code
TL;DR
HCPCS J3373 is the Level II code for Injection, vancomycin hydrochloride, 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $0.032 per billing unit, down 3.0% from July 2026. The practitioner MUE allows up to 600 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 70 NDCs to it, sold as Vancomycin HCl by Hikma Pharmaceuticals USA Inc., Baxter Healthcare Corporation, Henry Schein Inc.. No current Billing and Coding Article lists J3373, 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 J3373 at $0.032 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.033 in July 2026. Beneficiary coinsurance is 20%.
| Quarter | Payment limit | Per | Coinsurance |
|---|---|---|---|
| October 2026 | $0.032 | 10 MG | 20% |
| July 2026 | $0.033 | 10 MG | — |
NDC to HCPCS billing-unit conversion
The October 2026 ASP crosswalk maps 70 NDCs from 15 labelers to J3373. Report the NDC in the claim's drug segment and bill the number of J3373 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.
| NDC | Drug name | Labeler | Package size | Billing units / package |
|---|---|---|---|---|
| 00143-9355-10 | Vancomycin HCl | Hikma Pharmaceuticals USA Inc. | 1 × 10 | 750 |
| 00143-9357-10 | Vancomycin HCl | Hikma Pharmaceuticals USA Inc. | 1 × 10 | 1000 |
| 00143-9358-01 | Vancomycin HCl | Hikma Pharmaceuticals USA Inc. | 1 × 1 | 500 |
| 00143-9359-01 | Vancomycin HCl | Hikma Pharmaceuticals USA Inc. | 1 × 1 | 1000 |
| 00338-0122-04 | Vancomycin HCl | Baxter Healthcare Corporation | 250 × 4 | 500 |
| 00338-0124-04 | Vancomycin HCl | Baxter Healthcare Corporation | 300 × 4 | 600 |
| 00338-3551-48 | Vancomycin HCl | Baxter Healthcare Corporation | 100 × 1 | 600 |
| 00338-3552-48 | Vancomycin HCl | Baxter Healthcare Corporation | 200 × 1 | 600 |
| 00338-3580-48 | Vancomycin HCl | Baxter Healthcare Corporation | 150 × 1 | 450 |
| 00338-3581-01 | Vancomycin HCl | Baxter Healthcare Corporation | 100 × 1 | 600 |
| 00338-3582-01 | Vancomycin HCl | Baxter Healthcare Corporation | 150 × 1 | 450 |
| 00338-3583-01 | Vancomycin HCl | Baxter Healthcare Corporation | 200 × 1 | 600 |
| 00404-9965-99 | Vancomycin HCl | Henry Schein Inc. | 1 × 1 | 50 |
| 00409-1319-01 | Vancomycin HCl | Pfizer Inc | 1 × 1 | 1000 |
| 00409-3515-01 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 1500 |
| 00409-4332-01 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 500 |
| 00409-5017-01 | Vancomycin HCl | Pfizer Inc | 1 × 1 | 1000 |
| 00409-6509-01 | Vancomycin HCl | Pfizer Inc | 1 × 1 | 500 |
| 00409-6509-49 | Vancomycin HCl | Pfizer Inc | 1 × 1 | 500 |
| 00409-6531-01 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 750 |
| 00409-6531-02 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 750 |
| 00409-6533-21 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 1000 |
| 00409-6533-31 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 1000 |
| 00409-6534-01 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 500 |
| 00409-6535-01 | Vancomycin HCl | Pfizer Inc | 1 × 10 | 1000 |
| 16714-0309-10 | Vancomycin HCl | Northstar RxLLC | 1 × 10 | 1000 |
| 25021-0150-10 | Vancomycin HCl | Sagent Pharmaceuticals | 1 × 10 | 500 |
| 25021-0151-20 | Vancomycin HCl | Sagent Pharmaceuticals | 1 × 10 | 1000 |
| 25021-0157-99 | Vancomycin HCl | Sagent Pharmaceuticals | 1 × 1 | 500 |
| 25021-0158-99 | Vancomycin HCl | Sagent Pharmaceuticals | 1 × 1 | 1000 |
| 63323-0203-20 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 10 | 750 |
| 63323-0203-26 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 10 | 750 |
| 63323-0221-10 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 25 | 1250 |
| 63323-0221-16 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 25 | 1250 |
| 63323-0284-20 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 10 | 1000 |
| 63323-0284-26 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 10 | 1000 |
| 63323-0295-61 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 1 | 500 |
| 63323-0295-66 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 1 | 500 |
| 63323-0314-61 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 1 | 1000 |
| 63323-0314-66 | Vancomycin HCl | FreseniUS Kabi USA, LLC | 1 × 1 | 1000 |
| 67457-0339-50 | Vancomycin HCl | Mylan Institutional LLC | 1 × 10 | 500 |
| 67457-0340-01 | Vancomycin HCl | Mylan Institutional LLC | 1 × 10 | 1000 |
| 67457-0341-05 | Vancomycin HCl | Mylan Institutional LLC | 1 × 1 | 500 |
| 67457-0342-10 | Vancomycin HCl | Mylan Institutional LLC | 1 × 1 | 1000 |
| 68001-0407-75 | Vancomycin HCl | BluePoint Laboratories | 1 × 1 | 1000 |
| 68462-0955-51 | Vancomycin HCl | Glenmark Pharmaceuticals Inc., USA | 1 × 10 | 500 |
| 68462-0956-11 | Vancomycin HCl | Glenmark Pharmaceuticals Inc., USA | 1 × 10 | 1000 |
| 70436-0020-82 | Vancomycin HCl | Slate Run Pharmaceuticals | 1 × 10 | 500 |
| 70436-0021-82 | Vancomycin HCl | Slate Run Pharmaceuticals | 1 × 10 | 1000 |
| 70436-0022-82 | Vancomycin HCl | Slate Run Pharmaceuticals | 1 × 1 | 500 |
| 70436-0023-82 | Vancomycin HCl | Slate Run Pharmaceuticals | 1 × 1 | 1000 |
| 70594-0045-02 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 10 | 500 |
| 70594-0046-02 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 10 | 1000 |
| 70594-0047-01 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 1 | 500 |
| 70594-0048-01 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 1 | 1000 |
| 70594-0122-02 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 10 | 500 |
| 70594-0123-02 | Vancomycin HCl | Xellia Pharmaceuticals USA, LLC. | 1 × 10 | 1000 |
| 70860-0104-10 | Vancomycin HCl | Athenex Pharmaceutical Division, LLC | 1 × 10 | 500 |
| 70860-0105-20 | Vancomycin HCl | Athenex Pharmaceutical Division, LLC | 1 × 10 | 1000 |
| 71288-0022-11 | Vancomycin HCl | Meitheal Pharmaceuticals Inc. | 1 × 10 | 500 |
Medically Unlikely Edits (MUE)
CMS publishes 3 MUE values for J3373. For practitioners the limit is 600 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.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 600 | 3 Date of Service Edit: Clinical | Prescribing Information |
| Facility outpatient hospital | 600 | 3 Date of Service Edit: Clinical | Prescribing Information |
| DME supplier | 600 | 3 Date of Service Edit: Clinical | Prescribing Information |
NCCI edits and add-on relationships
No active practitioner PTP pair lists J3373 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.
J3373 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 J3373 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, J3373 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.
Common denials for J3373 and how to prevent them
How QuickIntell checks J3373 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.
Frequently asked questions — HCPCS J3373
What does HCPCS code J3373 describe?
J3373 is defined by CMS as "Injection, vancomycin hydrochloride, 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 J3373 in October 2026?
The ASP-based payment limit is $0.032 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 $0.033.
How many units of J3373 can be billed per day?
The practitioner Medically Unlikely Edit is 600 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 J3373?
The October 2026 ASP crosswalk lists 70 NDCs from 15 labelers: Vancomycin HCl (Hikma Pharmaceuticals USA Inc.); Vancomycin HCl (Baxter Healthcare Corporation); Vancomycin HCl (Henry Schein Inc.); Vancomycin HCl (Pfizer Inc). For example NDC 00143-9355-10 is a 1 package equal to 750 billing units. The crosswalk's billing-units-per-package figure converts each package into J3373 units.
Does J3373 have NCCI bundling edits?
No active practitioner PTP pairs list J3373 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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare Part B Drug Payment Limit File, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csvSHA-256 508fba376a29e099…
- Medicare Part B Drug Payment Limit File, July 2026Version July 2026 · effective 2026-07-01 · file section 508 version of July 2026 Medicare Part B Payment Limit File updated 082026.csvSHA-256 13bb5b644b92b574…
- ASP NDC-HCPCS Crosswalk, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 ASP NDC-HCPCS Crosswalk 091126.csvSHA-256 5cb78f0c2ee786ba…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI Add-On Code edits, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file AOC_V2026Q4-F-MCR.txtSHA-256 3c92860fb5001967…
- OPPS Addendum B, July 2026Version July 2026 · effective 2026-07-01 · file 2026 July Web Addendum B.07.13.26.csvSHA-256 e50a1fa958ed2bb2…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-09-24 · effective 2026-09-20 · file article.csvSHA-256 f31932f1df3b4035…
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.