Mitomycin injection
Products billed under this code include Mitomycin.
Payment limit per 5 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 Mitomycin.
Payment limit per 5 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 |
|---|---|---|---|---|
| Mitomycin | Hikma Pharmaceuticals USA Inc. | 00143-9135-01 | 4 | $139.352 |
| Mitomycin | Hikma Pharmaceuticals USA Inc. | 00143-9136-01 | 8 | $278.704 |
| Mitomycin | Hikma Pharmaceuticals USA Inc. | 00143-9279-01 | 4 | $139.352 |
| Mitomycin | Hikma Pharmaceuticals USA Inc. | 00143-9280-01 | 8 | $278.704 |
| Mitomycin | Accord Healthcare Inc | 16729-0115-05 | 1 | $34.838 |
| Mitomycin | Sagent Pharmaceuticals | 25021-0250-20 | 1 | $34.838 |
| Mitomycin | Sagent Pharmaceuticals | 25021-0251-50 | 4 | $139.352 |
| Mitomycin | Sagent Pharmaceuticals | 25021-0252-51 | 8 | $278.704 |
| Mitomycin | Eugia US LLC | 55150-0450-01 | 1 | $34.838 |
| Mitomycin | Eugia US LLC | 55150-0451-01 | 4 | $139.352 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Mitomycin | Eugia US LLC | 55150-0452-01 | 8 | $278.704 |
| Mitomycin | FreseniUS Kabi USA, LLC | 65219-0564-20 | 1 | $34.838 |
| Mitomycin | FreseniUS Kabi USA, LLC | 65219-0566-20 | 4 | $139.352 |
| Mitomycin | FreseniUS Kabi USA, LLC | 65219-0568-00 | 8 | $278.704 |
| Mitomycin | BluePoint Laboratories | 68001-0389-36 | 1 | $34.838 |
| Mitomycin | BluePoint Laboratories | 68001-0615-36 | 1 | $34.838 |
| Mitomycin | BluePoint Laboratories | 68001-0616-77 | 4 | $139.352 |
| Mitomycin | BluePoint Laboratories | 68001-0617-79 | 8 | $278.704 |
| Mitomycin | Meitheal Pharmaceuticals Inc. | 71288-0137-20 | 1 | $34.838 |
| Mitomycin | Meitheal Pharmaceuticals Inc. | 71288-0138-50 | 4 | $139.352 |
| Mitomycin | Meitheal Pharmaceuticals Inc. | 71288-0139-51 | 8 | $278.704 |
| Mitomycin | Archis Pharma LLC | 72819-0152-05 | 1 | $34.838 |
| Mitomycin | Archis Pharma LLC | 72819-0152-95 | 1 | $34.838 |
| Mitomycin | Archis Pharma LLC | 72819-0153-02 | 4 | $139.352 |
| Mitomycin | Archis Pharma LLC | 72819-0154-04 | 8 | $278.704 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $34.838 | +$0.731 | 5 MG | Mitomycin injection | v1, posted September 17, 2026 |
| 3Q26 | $34.107 | +$5.648 | 5 MG | Mitomycin injection | v1, posted September 15, 2026 |
| 2Q26 | $28.459 | +$2.355 | 5 MG | Mitomycin injection | v1, posted September 15, 2026 |
| 1Q26 | $26.104 | +$5.756 | 5 MG | Mitomycin injection | v1, posted September 15, 2026 |
| 4Q25 | $20.348 | −$7.924 | 5 MG | Mitomycin injection | v1, posted September 8, 2026 |
| 3Q25 | $28.272 | +$2.67 | 5 MG | Mitomycin injection | v1, posted March 10, 2026 |
| 2Q25 | $25.602 | −$20.746 | 5 MG | Mitomycin injection | v1, posted March 10, 2026 |
| 1Q25 | $46.348 | +$3.843 | 5 MG | Mitomycin injection | v1, posted December 19, 2025 |
| 4Q24 | $42.505 | −$11.659 | 5 MG | Mitomycin injection | v1, posted June 11, 2025 |
| 3Q24 | $54.164 | −$12.867 | 5 MG | Mitomycin injection | v1, posted June 11, 2025 |
| 2Q24 | $67.031 | +$3.683 | 5 MG | Mitomycin injection | v1, posted March 11, 2025 |
| 1Q24 | $63.348 | −$32.262 | 5 MG | Mitomycin injection | v1, posted December 19, 2024 |
| 4Q23 | $95.61 | +$16.586 | 5 MG | Mitomycin injection | v1, posted October 10, 2024 |
| 3Q23 | $79.024 | +$55.00 | 5 MG | Mitomycin injection | v1, posted June 5, 2024 |
| 2Q23 | $24.024 | −$20.446 | 5 MG | Mitomycin injection | v1, posted February 23, 2024 |
| 1Q23 | $44.47 | −$9.824 | 5 MG | Mitomycin injection | v1, posted December 6, 2023 |
| 4Q22 | $54.294 | +$7.134 | 5 MG | Mitomycin injection | v1, posted June 22, 2023 |
| 3Q22 | $47.16 | −$1.707 | 5 MG | Mitomycin injection | v1, posted June 9, 2023 |
| 2Q22 | $48.867 | −$1.796 | 5 MG | Mitomycin injection | v1, posted December 14, 2022 |
| 1Q22 | $50.663 | +$12.034 | 5 MG | Mitomycin injection | v1, posted June 8, 2022 |
| 4Q21 | $38.629 | −$5.753 | 5 MG | Mitomycin injection | v1, posted June 2, 2022 |
| 3Q21 | $44.382 | +$1.622 | 5 MG | Mitomycin injection | v1, posted June 2, 2022 |
| 2Q21 | $42.76 | −$11.478 | 5 MG | Mitomycin injection | v1, posted March 1, 2022 |
| 1Q21 | $54.238 | – | 5 MG | Mitomycin injection | 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.