Lyumjev for insulin pump use
Products billed under this code include Lyumjev.
Payment limit per 50 UNITS, by effective quarter, 3Q23 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J1813
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 |
|---|---|---|---|---|
| Lyumjev | Eli Lilly and Company | 00002-7728-01 | 20 | $78.06 |
| Lyumjev | A-S Medication Solutions | 50090-7433-00 | 20 | $78.06 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3.903 | −$0.899 | 50 UNITS | Lyumjev for insulin pump use | v1, posted September 17, 2026 |
| 3Q26 | $4.802 | −$10.302 | 50 UNITS | Lyumjev for insulin pump use | v1, posted September 15, 2026 |
| 2Q26 | $15.104 | $0.00 | 50 UNITS | Lyumjev for insulin pump use | v1, posted September 15, 2026 |
| 1Q26 | $15.104 | −$0.019 | 50 UNITS | Lyumjev for insulin pump use | v1, posted September 15, 2026 |
| 4Q25 | $15.123 | −$0.149 | 50 UNITS | Lyumjev for insulin pump use | v1, posted September 8, 2026 |
| 3Q25 | $15.272 | −$0.056 | 50 UNITS | Lyumjev for insulin pump use | v1, posted March 10, 2026 |
| 2Q25 | $15.328 | −$0.148 | 50 UNITS | Lyumjev for insulin pump use | v1, posted March 10, 2026 |
| 1Q25 | $15.476 | −$0.058 | 50 UNITS | Lyumjev for insulin pump use | v1, posted December 19, 2025 |
| 4Q24 | $15.534 | +$0.003 | 50 UNITS | Lyumjev for insulin pump use | v1, posted June 11, 2025 |
| 3Q24 | $15.531 | −$0.147 | 50 UNITS | Lyumjev for insulin pump use | v1, posted June 11, 2025 |
| 2Q24 | $15.678 | +$0.105 | 50 UNITS | Lyumjev for insulin pump use | v1, posted March 11, 2025 |
| 1Q24 | $15.573 | −$0.102 | 50 UNITS | Lyumjev for insulin pump use | v1, posted December 19, 2024 |
| 4Q23 | $15.675 | −$0.055 | 50 UNITS | Lyumjev for insulin pump use | v1, posted October 10, 2024 |
| 3Q23 | $15.73 | – | 50 UNITS | Lyumjev for insulin pump use | v1, posted June 5, 2024 |
“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
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024