HCPCS drug code · CMS crosswalk
Gablofen J-Code / HCPCS Code
In short
CMS assigns Gablofen NDCs to 2 HCPCS codes: J0475 (per 10 mg), J0476 (per 50 mcg). Which one applies depends on the product; the table lists each NDC with its code.
Reference
- J0475
- Injection, baclofen, 10 mgBilling unit: 10 mg
- J0476
- Injection, baclofen, 50 mcg for intrathecal trialBilling unit: 50 mcg
- Labelers
- Piramal Critical Care Inc
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Gablofen units and claim line
Enter the dose given to get the J0475 units and the NDC line for the CMS-1500 and the 837P. This builds the J0475 line; use the code page for J0476.
Enter the dose given to build the claim line.
Gablofen NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 66794-0155-01 | J0475 | Piramal Critical Care Inc | 20 | 1 |
| 66794-0155-02 | J0475 | Piramal Critical Care Inc | 20 | 1 |
| 66794-0156-01 | J0475 | Piramal Critical Care Inc | 20 | 2 |
| 66794-0156-02 | J0475 | Piramal Critical Care Inc | 20 | 2 |
| 66794-0157-01 | J0475 | Piramal Critical Care Inc | 20 | 4 |
| 66794-0157-02 | J0475 | Piramal Critical Care Inc | 20 | 4 |
| 66794-0151-01 | J0476 | Piramal Critical Care Inc | 1 | 1 |
Gablofen: common questions
- What is the J-code for Gablofen?
- CMS assigns Gablofen NDCs to 2 HCPCS codes: J0475 (per 10 mg), J0476 (per 50 mcg). Which one applies depends on the product; the table lists each NDC with its code.
- How many J0475 billing units are in a package of Gablofen?
- CMS lists 1 to 4 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- How many J0476 billing units are in a package of Gablofen?
- CMS lists 1 billing units per package, depending on the NDC, where one unit is 50 mcg. Units to report are based on the dose given, not the package.
- Is J0475 a CPT code?
- No. J0475 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.