Inj., guselkumab, 1 mg
Products billed under this code include Tremfya.
Payment limit per 1 MG, 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 J1628
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 |
|---|---|---|---|---|
| Tremfya | Janssen Biotech, Inc. | 57894-0640-01 | 100 | $6,699.80 |
| Tremfya | Janssen Biotech, Inc. | 57894-0640-06 | 100 | $6,699.80 |
| Tremfya | Janssen Biotech, Inc. | 57894-0640-11 | 100 | $6,699.80 |
| Tremfya | Janssen Biotech, Inc. | 57894-0650-02 | 200 | $13,399.60 |
| Tremfya | Janssen Biotech, Inc. | 57894-0651-02 | 200 | $13,399.60 |
| Tremfya | Janssen Biotech, Inc. | 57894-0651-04 | 400 | $26,799.20 |
| Tremfya | Janssen Biotech, Inc. | 57894-0651-22 | 200 | $13,399.60 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $66.998 | +$0.078 | 1 MG | Inj., guselkumab, 1 mg | v1, posted September 17, 2026 |
| 3Q26 | $66.92 | −$0.893 | 1 MG | Inj., guselkumab, 1 mg | v1, posted September 15, 2026 |
| 2Q26 | $67.813 | −$5.124 | 1 MG | Inj., guselkumab, 1 mg | v1, posted September 15, 2026 |
| 1Q26 | $72.937 | −$3.035 | 1 MG | Inj., guselkumab, 1 mg | v1, posted September 15, 2026 |
| 4Q25 | $75.972 | +$1.109 | 1 MG | Inj., guselkumab, 1 mg | v1, posted September 8, 2026 |
| 3Q25 | $74.863 | +$4.436 | 1 MG | Inj., guselkumab, 1 mg | v1, posted March 10, 2026 |
| 2Q25 | $70.427 | −$3.096 | 1 MG | Inj., guselkumab, 1 mg | v1, posted March 10, 2026 |
| 1Q25 | $73.523 | – | 1 MG | Inj., guselkumab, 1 mg | 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