Inj, levothyroxine nos 10mcg
Products billed under this code include Levothyroxine Sodium.
Payment limit per 10 MCG, by effective quarter, 1Q25 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0650
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Levothyroxine Sodium | Sagent Pharmaceuticals | 25021-0468-10 | 10 | $65.81 |
| Levothyroxine Sodium | Sagent Pharmaceuticals | 25021-0469-10 | 20 | $131.62 |
| Levothyroxine Sodium | Sagent Pharmaceuticals | 25021-0470-10 | 50 | $329.05 |
| Levothyroxine Sodium | Endo USA, Inc. | 42023-0201-01 | 10 | $65.81 |
| Levothyroxine Sodium | Endo USA, Inc. | 42023-0202-01 | 20 | $131.62 |
| Levothyroxine Sodium | Endo USA, Inc. | 42023-0203-01 | 50 | $329.05 |
| Levothyroxine Sodium | FreseniUS Kabi USA, LLC | 63323-0647-10 | 20 | $131.62 |
| Levothyroxine Sodium | FreseniUS Kabi USA, LLC | 63323-0648-10 | 50 | $329.05 |
| Levothyroxine Sodium | FreseniUS Kabi USA, LLC | 63323-0649-07 | 10 | $65.81 |
| Levothyroxine Sodium | FreseniUS Kabi USA, LLC | 63323-0649-16 | 10 | $65.81 |
Show all 18 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Levothyroxine Sodium | FreseniUS Kabi USA, LLC | 63323-0649-94 | 10 | $65.81 |
| Levothyroxine Sodium | Zydus Pharmaceuticals (Usa) Inc. | 70710-1833-01 | 10 | $65.81 |
| Levothyroxine Sodium | Zydus Pharmaceuticals (Usa) Inc. | 70710-1834-01 | 20 | $131.62 |
| Levothyroxine Sodium | Zydus Pharmaceuticals (Usa) Inc. | 70710-1835-01 | 50 | $329.05 |
| Levothyroxine Sodium | Athenex Pharmaceutical Division, LLC | 70860-0451-10 | 10 | $65.81 |
| Levothyroxine Sodium | Athenex Pharmaceutical Division, LLC | 70860-0452-10 | 20 | $131.62 |
| Levothyroxine Sodium | Athenex Pharmaceutical Division, LLC | 70860-0453-10 | 50 | $329.05 |
| Levothyroxine Sodium | Fosun Pharma USA Inc. | 72266-0261-01 | 10 | $65.81 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $6.581 | +$1.485 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted September 17, 2026 |
| 3Q26 | $5.096 | −$2.315 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted September 15, 2026 |
| 2Q26 | $7.411 | +$1.428 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted September 15, 2026 |
| 1Q26 | $5.983 | −$0.889 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted September 15, 2026 |
| 4Q25 | $6.872 | −$0.826 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted September 8, 2026 |
| 3Q25 | $7.698 | +$0.437 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted March 10, 2026 |
| 2Q25 | $7.261 | +$1.871 | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted March 10, 2026 |
| 1Q25 | $5.39 | – | 10 MCG | Inj, levothyroxine nos 10mcg | v1, posted December 19, 2025 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025