Inj leu acet lutr dpt 7.5 mg
Products billed under this code include Leuprolide Acetate, Lutrate Depot.
Payment limit per 7.5 MG, 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 this code include Leuprolide Acetate, Lutrate Depot.
Payment limit per 7.5 MG, by effective quarter, 3Q23 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 |
|---|---|---|---|---|
| Leuprolide Acetate | Cipla USA, Inc. | 69097-0909-50 | 3 | $2,051.58 |
| Lutrate Depot | Avyxa Pharma, LLC | 83831-0134-01 | 3 | $2,051.58 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $683.86 | −$3.427 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted September 17, 2026 |
| 3Q26 | $687.287 | −$6.27 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted September 15, 2026 |
| 2Q26 | $693.557 | −$13.11 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted September 15, 2026 |
| 1Q26 | $706.667 | $0.00 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted September 15, 2026 |
| 4Q25 | $706.667 | +$485.924 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted September 8, 2026 |
| 3Q25 | $220.743 | $0.00 | 7.5 MG | Inj leu acet lutr dpt 7.5 mg | v1, posted March 10, 2026 |
| 2Q25 | $220.743 | −$14.537 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted March 10, 2026 |
| 1Q25 | $235.28 | −$22.424 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted December 19, 2025 |
| 4Q24 | $257.704 | −$48.954 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted June 11, 2025 |
| 3Q24 | $306.658 | +$25.086 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted June 11, 2025 |
| 2Q24 | $281.572 | −$73.707 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted March 11, 2025 |
| 1Q24 | $355.279 | −$6.774 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted December 19, 2024 |
| 4Q23 | $362.053 | −$63.425 | 7.5 MG | Leuprolide depot cipla 7.5mg | v1, posted October 10, 2024 |
| 3Q23 | $425.478 | – | 7.5 MG | Leuprolide depot cipla 7.5mg | 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.