Leuprolide acetate /3.75 mg
Products billed under this code include Lupron Depot.
Payment limit per 3.75 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under this code include Lupron Depot.
Payment limit per 3.75 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.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 |
|---|---|---|---|---|
| Lupron Depot | AbbVie Inc. | 00074-2108-03 | 2 | $3,598.104 |
| Lupron Depot | AbbVie Inc. | 00074-2282-03 | 3 | $5,397.156 |
| Lupron Depot | AbbVie Inc. | 00074-2440-03 | 4 | $7,196.208 |
| Lupron Depot | AbbVie Inc. | 00074-3575-01 | 12 | $21,588.624 |
| Lupron Depot | AbbVie Inc. | 00074-3641-03 | 1 | $1,799.052 |
| Lupron Depot | AbbVie Inc. | 00074-3663-03 | 3 | $5,397.156 |
| Lupron Depot | AbbVie Inc. | 00074-3779-03 | 3 | $5,397.156 |
| Lupron Depot | AbbVie Inc. | 00074-9694-03 | 8 | $14,392.416 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $1,799.052 | −$42.209 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted September 17, 2026 |
| 3Q26 | $1,841.261 | +$75.687 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted September 15, 2026 |
| 2Q26 | $1,765.574 | +$1.705 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted September 15, 2026 |
| 1Q26 | $1,763.869 | +$33.545 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted September 15, 2026 |
| 4Q25 | $1,730.324 | −$6.773 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted September 8, 2026 |
| 3Q25 | $1,737.097 | +$66.801 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted March 10, 2026 |
| 2Q25 | $1,670.296 | +$3.52 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted March 10, 2026 |
| 1Q25 | $1,666.776 | +$49.129 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted December 19, 2025 |
| 4Q24 | $1,617.647 | −$56.286 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 11, 2025 |
| 3Q24 | $1,673.933 | +$97.814 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 11, 2025 |
| 2Q24 | $1,576.119 | +$11.515 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted March 11, 2025 |
| 1Q24 | $1,564.604 | +$40.268 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted December 19, 2024 |
| 4Q23 | $1,524.336 | −$19.18 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted October 10, 2024 |
| 3Q23 | $1,543.516 | +$62.631 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 5, 2024 |
| 2Q23 | $1,480.885 | +$6.708 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted February 23, 2024 |
| 1Q23 | $1,474.177 | −$3.371 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted December 6, 2023 |
| 4Q22 | $1,477.548 | −$17.819 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 22, 2023 |
| 3Q22 | $1,495.367 | +$73.812 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 9, 2023 |
| 2Q22 | $1,421.555 | +$55.546 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted December 14, 2022 |
| 1Q22 | $1,366.009 | −$40.357 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 8, 2022 |
| 4Q21 | $1,406.366 | +$98.885 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 2, 2022 |
| 3Q21 | $1,307.481 | +$39.479 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted June 2, 2022 |
| 2Q21 | $1,268.002 | −$314.13 | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted March 1, 2022 |
| 1Q21 | $1,582.132 | – | 3.75 MG | Leuprolide acetate /3.75 mg | v1, posted December 10, 2021 |
“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.