Oral everolimus
Products billed under this code include Everolimus, Zortress.
Payment limit per 0.25 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 J7527
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 |
|---|---|---|---|---|
| Everolimus | Hikma Pharmaceuticals USA Inc. | 00054-0470-21 | 60 | $67.56 |
| Everolimus | Hikma Pharmaceuticals USA Inc. | 00054-0471-21 | 120 | $135.12 |
| Everolimus | Hikma Pharmaceuticals USA Inc. | 00054-0472-21 | 180 | $202.68 |
| Everolimus | Endo USA, Inc. | 49884-0158-02 | 60 | $67.56 |
| Everolimus | Endo USA, Inc. | 49884-0159-02 | 120 | $135.12 |
| Everolimus | Endo USA, Inc. | 49884-0160-02 | 180 | $202.68 |
| Everolimus | Endo USA, Inc. | 49884-0283-02 | 240 | $270.24 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0379-06 | 60 | $67.56 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0379-60 | 60 | $67.56 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0380-06 | 120 | $135.12 |
Show all 27 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0380-60 | 120 | $135.12 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0381-06 | 180 | $202.68 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0381-60 | 180 | $202.68 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0985-06 | 240 | $270.24 |
| Everolimus | Breckenridge Pharmaceutical, Inc. | 51991-0985-60 | 240 | $270.24 |
| Everolimus | Ascend Laboratories, LLC | 67877-0718-31 | 60 | $67.56 |
| Everolimus | Ascend Laboratories, LLC | 67877-0719-31 | 120 | $135.12 |
| Everolimus | Ascend Laboratories, LLC | 67877-0720-31 | 180 | $202.68 |
| Everolimus | Ascend Laboratories, LLC | 67877-0721-31 | 240 | $270.24 |
| Everolimus | Biocon Pharma Inc | 70377-0069-11 | 60 | $67.56 |
| Everolimus | Biocon Pharma Inc | 70377-0070-11 | 120 | $135.12 |
| Everolimus | Biocon Pharma Inc | 70377-0071-11 | 180 | $202.68 |
| Everolimus | Biocon Pharma Inc | 70377-0112-11 | 240 | $270.24 |
| Zortress | Novartis Pharmaceuticals Corporation | 00078-0414-20 | 120 | $135.12 |
| Zortress | Novartis Pharmaceuticals Corporation | 00078-0415-20 | 180 | $202.68 |
| Zortress | Novartis Pharmaceuticals Corporation | 00078-0417-20 | 60 | $67.56 |
| Zortress | Novartis Pharmaceuticals Corporation | 00078-0422-20 | 240 | $270.24 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $1.126 | −$0.037 | 0.25 MG | Oral everolimus | v1, posted September 17, 2026 |
| 3Q26 | $1.163 | −$0.081 | 0.25 MG | Oral everolimus | v1, posted September 15, 2026 |
| 2Q26 | $1.244 | +$0.068 | 0.25 MG | Oral everolimus | v1, posted September 15, 2026 |
| 1Q26 | $1.176 | −$0.194 | 0.25 MG | Oral everolimus | v1, posted September 15, 2026 |
| 4Q25 | $1.37 | −$0.616 | 0.25 MG | Oral everolimus | v1, posted September 8, 2026 |
| 3Q25 | $1.986 | −$0.032 | 0.25 MG | Oral everolimus | v1, posted March 10, 2026 |
| 2Q25 | $2.018 | −$0.304 | 0.25 MG | Oral everolimus | v1, posted March 10, 2026 |
| 1Q25 | $2.322 | +$0.116 | 0.25 MG | Oral everolimus | v1, posted December 19, 2025 |
| 4Q24 | $2.206 | +$0.004 | 0.25 MG | Oral everolimus | v1, posted June 11, 2025 |
| 3Q24 | $2.202 | −$0.482 | 0.25 MG | Oral everolimus | v1, posted June 11, 2025 |
| 2Q24 | $2.684 | −$0.067 | 0.25 MG | Oral everolimus | v1, posted March 11, 2025 |
| 1Q24 | $2.751 | −$0.115 | 0.25 MG | Oral everolimus | v1, posted December 19, 2024 |
| 4Q23 | $2.866 | −$0.335 | 0.25 MG | Oral everolimus | v1, posted October 10, 2024 |
| 3Q23 | $3.201 | +$0.085 | 0.25 MG | Oral everolimus | v1, posted June 5, 2024 |
| 2Q23 | $3.116 | −$0.483 | 0.25 MG | Oral everolimus | v1, posted February 23, 2024 |
| 1Q23 | $3.599 | −$0.508 | 0.25 MG | Oral everolimus | v1, posted December 6, 2023 |
| 4Q22 | $4.107 | −$0.605 | 0.25 MG | Oral everolimus | v1, posted June 22, 2023 |
| 3Q22 | $4.712 | −$0.97 | 0.25 MG | Oral everolimus | v1, posted June 9, 2023 |
| 2Q22 | $5.682 | −$0.014 | 0.25 MG | Oral everolimus | v1, posted December 14, 2022 |
| 1Q22 | $5.696 | −$0.227 | 0.25 MG | Oral everolimus | v1, posted June 8, 2022 |
| 4Q21 | $5.923 | −$0.01 | 0.25 MG | Oral everolimus | v1, posted June 2, 2022 |
| 3Q21 | $5.933 | −$0.76 | 0.25 MG | Oral everolimus | v1, posted June 2, 2022 |
| 2Q21 | $6.693 | −$0.304 | 0.25 MG | Oral everolimus | v1, posted March 1, 2022 |
| 1Q21 | $6.997 | – | 0.25 MG | Oral everolimus | 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.
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
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021