Products billed under this code include Bethkis, Kitabis PAK, Tobi, Tobramycin, Tobramycin inhalation.
Payment limit per 300 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 |
|---|---|---|---|---|
| Bethkis | Chiesi USA, Inc. | 10122-0820-28 | 28 | $319.312 |
| Bethkis | Chiesi USA, Inc. | 10122-0820-56 | 56 | $638.624 |
| Kitabis PAK | PARI Respiratory Equipment | 24492-0850-56 | 56 | $638.624 |
| Tobi | Viatris Specialty LLC | 49502-0345-73 | 56 | $638.624 |
| Tobramycin | Teva Pharmaceuticals USA, Inc. | 00093-3750-28 | 28 | $319.312 |
| Tobramycin | Teva Pharmaceuticals USA, Inc. | 00093-3750-63 | 56 | $638.624 |
| Tobramycin | Prasco Laboratories | 66993-0195-94 | 56 | $638.624 |
| Tobramycin | Lifestar Pharma | 70756-0617-56 | 56 | $638.624 |
| Tobramycin inhalation | Teva Pharmaceuticals USA, Inc. | 00093-4085-63 | 56 | $638.624 |
| Tobramycin inhalation | Northstar RxLLC | 16714-0119-03 | 56 | $638.624 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Tobramycin inhalation | Micro Labs Limited | 42571-0408-92 | 56 | $638.624 |
| Tobramycin inhalation | Dr. Reddy's Laboratories Inc. | 43598-0605-56 | 56 | $638.624 |
| Tobramycin inhalation | Dr. Reddy's Laboratories Inc. | 43598-0605-58 | 56 | $638.624 |
| Tobramycin inhalation | Sun Pharmaceutical Global FZE. | 47335-0171-49 | 56 | $638.624 |
| Tobramycin inhalation | American Health Packaging | 60687-0731-83 | 30 | $342.12 |
| Tobramycin inhalation | Amneal Pharmaceuticals, LLC | 65162-0914-46 | 56 | $638.624 |
| Tobramycin inhalation | Lupin Pharmaceuticals, Inc. | 68180-0962-56 | 56 | $638.624 |
| Tobramycin inhalation | Genericus, Inc. | 70644-0899-99 | 56 | $638.624 |
| Tobramycin inhalation | Lifestar Pharma | 70756-0604-56 | 56 | $638.624 |
| Tobramycin inhalation | Northstar RxLLC | 72603-0430-56 | 56 | $638.624 |
| Tobramycin inhalation | Northstar RxLLC | 72603-0630-56 | 56 | $638.624 |
| Tobramycin inhalation | Ritedose Pharmaceuticals, LLC | 76204-0029-56 | 56 | $638.624 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $11.404 | −$0.901 | 300 MG | Tobramycin non-comp unit | v1, posted September 17, 2026 |
| 3Q26 | $12.305 | +$4.539 | 300 MG | Tobramycin non-comp unit | v1, posted September 15, 2026 |
| 2Q26 | $7.766 | −$4.704 | 300 MG | Tobramycin non-comp unit | v1, posted September 15, 2026 |
| 1Q26 | $12.47 | −$3.746 | 300 MG | Tobramycin non-comp unit | v1, posted September 15, 2026 |
| 4Q25 | $16.216 | +$1.759 | 300 MG | Tobramycin non-comp unit | v1, posted September 8, 2026 |
| 3Q25 | $14.457 | −$0.346 | 300 MG | Tobramycin non-comp unit | v1, posted March 10, 2026 |
| 2Q25 | $14.803 | −$1.20 | 300 MG | Tobramycin non-comp unit | v1, posted March 10, 2026 |
| 1Q25 | $16.003 | +$0.051 | 300 MG | Tobramycin non-comp unit | v1, posted December 19, 2025 |
| 4Q24 | $15.952 | −$1.085 | 300 MG | Tobramycin non-comp unit | v1, posted June 11, 2025 |
| 3Q24 | $17.037 | +$0.505 | 300 MG | Tobramycin non-comp unit | v1, posted June 11, 2025 |
| 2Q24 | $16.532 | −$5.262 | 300 MG | Tobramycin non-comp unit | v1, posted March 11, 2025 |
| 1Q24 | $21.794 | −$2.282 | 300 MG | Tobramycin non-comp unit | v1, posted December 19, 2024 |
| 4Q23 | $24.076 | −$5.548 | 300 MG | Tobramycin non-comp unit | v1, posted October 10, 2024 |
| 3Q23 | $29.624 | +$4.362 | 300 MG | Tobramycin non-comp unit | v1, posted June 5, 2024 |
| 2Q23 | $25.262 | −$3.917 | 300 MG | Tobramycin non-comp unit | v1, posted February 23, 2024 |
| 1Q23 | $29.179 | +$5.929 | 300 MG | Tobramycin non-comp unit | v1, posted December 6, 2023 |
| 4Q22 | $23.25 | −$4.524 | 300 MG | Tobramycin non-comp unit | v1, posted June 22, 2023 |
| 3Q22 | $27.774 | +$4.003 | 300 MG | Tobramycin non-comp unit | v1, posted June 9, 2023 |
| 2Q22 | $23.771 | −$3.234 | 300 MG | Tobramycin non-comp unit | v1, posted December 14, 2022 |
| 1Q22 | $27.005 | −$11.579 | 300 MG | Tobramycin non-comp unit | v1, posted June 8, 2022 |
| 4Q21 | $38.584 | +$3.84 | 300 MG | Tobramycin non-comp unit | v1, posted June 2, 2022 |
| 3Q21 | $34.744 | +$4.819 | 300 MG | Tobramycin non-comp unit | v1, posted June 2, 2022 |
| 2Q21 | $29.925 | −$12.745 | 300 MG | Tobramycin non-comp unit | v1, posted March 1, 2022 |
| 1Q21 | $42.67 | – | 300 MG | Tobramycin non-comp unit | 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.
