Injection, fulvestrant
Products billed under this code include Faslodex, Fulvestrant.
Payment limit per 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 J9395
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 |
|---|---|---|---|---|
| Faslodex | AstraZeneca Pharmaceuticals LP | 00310-0720-10 | 20 | $100.42 |
| Fulvestrant | Hikma Pharmaceuticals USA Inc. | 00143-9022-02 | 20 | $100.42 |
| Fulvestrant | Sandoz Inc. | 00781-3532-12 | 20 | $100.42 |
| Fulvestrant | Sandoz Inc. | 00781-9055-12 | 20 | $100.42 |
| Fulvestrant | Northstar RxLLC | 16714-0070-02 | 20 | $100.42 |
| Fulvestrant | Accord Healthcare Inc | 16729-0436-30 | 20 | $100.42 |
| Fulvestrant | Sagent Pharmaceuticals | 25021-0462-74 | 20 | $100.42 |
| Fulvestrant | Sagent Pharmaceuticals | 25021-0471-74 | 20 | $100.42 |
| Fulvestrant | Dr. Reddy's Laboratories Inc. | 43598-0262-02 | 20 | $100.42 |
| Fulvestrant | Dr. Reddy's Laboratories Inc. | 43598-0262-23 | 20 | $100.42 |
Show all 22 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Fulvestrant | Eugia US LLC | 55150-0394-02 | 20 | $100.42 |
| Fulvestrant | Alembic Pharmaceuticals Inc. | 62332-0650-10 | 20 | $100.42 |
| Fulvestrant | FreseniUS Kabi USA, LLC | 63323-0715-05 | 20 | $100.42 |
| Fulvestrant | BluePoint Laboratories | 68001-0484-85 | 20 | $100.42 |
| Fulvestrant | BluePoint Laboratories | 68001-0522-85 | 20 | $100.42 |
| Fulvestrant | BluePoint Laboratories | 68001-0626-85 | 20 | $100.42 |
| Fulvestrant | Amneal Pharmaceuticals, LLC | 70121-1463-02 | 20 | $100.42 |
| Fulvestrant | Xiromed, LLC | 70700-0284-98 | 20 | $100.42 |
| Fulvestrant | Zydus Pharmaceuticals (USA) Inc. | 70710-1688-08 | 20 | $100.42 |
| Fulvestrant | Athenex Pharmaceutical Division, LLC | 70860-0211-74 | 20 | $100.42 |
| Fulvestrant | Meitheal Pharmaceuticals Inc. | 71288-0555-86 | 20 | $100.42 |
| Fulvestrant | Avenacy Inc. | 83634-0203-74 | 20 | $100.42 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $5.021 | −$0.256 | 25 MG | Injection, fulvestrant | v1, posted September 17, 2026 |
| 3Q26 | $5.277 | +$0.339 | 25 MG | Injection, fulvestrant | v1, posted September 15, 2026 |
| 2Q26 | $4.938 | −$0.782 | 25 MG | Injection, fulvestrant | v1, posted September 15, 2026 |
| 1Q26 | $5.72 | −$1.008 | 25 MG | Injection, fulvestrant | v1, posted September 15, 2026 |
| 4Q25 | $6.728 | −$0.249 | 25 MG | Injection, fulvestrant | v1, posted September 8, 2026 |
| 3Q25 | $6.977 | +$0.082 | 25 MG | Injection, fulvestrant | v1, posted March 10, 2026 |
| 2Q25 | $6.895 | +$0.239 | 25 MG | Injection, fulvestrant | v1, posted March 10, 2026 |
| 1Q25 | $6.656 | −$0.85 | 25 MG | Injection, fulvestrant | v1, posted December 19, 2025 |
| 4Q24 | $7.506 | −$1.22 | 25 MG | Injection, fulvestrant | v1, posted June 11, 2025 |
| 3Q24 | $8.726 | +$0.557 | 25 MG | Injection, fulvestrant | v1, posted June 11, 2025 |
| 2Q24 | $8.169 | −$0.276 | 25 MG | Injection, fulvestrant | v1, posted March 11, 2025 |
| 1Q24 | $8.445 | +$0.088 | 25 MG | Injection, fulvestrant | v1, posted December 19, 2024 |
| 4Q23 | $8.357 | −$1.113 | 25 MG | Injection, fulvestrant | v1, posted October 10, 2024 |
| 3Q23 | $9.47 | −$2.616 | 25 MG | Injection, fulvestrant | v1, posted June 5, 2024 |
| 2Q23 | $12.086 | −$0.575 | 25 MG | Injection, fulvestrant | v1, posted February 23, 2024 |
| 1Q23 | $12.661 | +$1.613 | 25 MG | Injection, fulvestrant | v1, posted December 6, 2023 |
| 4Q22 | $11.048 | −$2.969 | 25 MG | Injection, fulvestrant | v1, posted June 22, 2023 |
| 3Q22 | $14.017 | +$2.406 | 25 MG | Injection, fulvestrant | v1, posted June 9, 2023 |
| 2Q22 | $11.611 | −$4.035 | 25 MG | Injection, fulvestrant | v1, posted December 14, 2022 |
| 1Q22 | $15.646 | −$0.333 | 25 MG | Injection, fulvestrant | v1, posted June 8, 2022 |
| 4Q21 | $15.979 | −$11.617 | 25 MG | Injection, fulvestrant | v1, posted June 2, 2022 |
| 3Q21 | $27.596 | −$17.506 | 25 MG | Injection, fulvestrant | v1, posted June 2, 2022 |
| 2Q21 | $45.102 | −$9.663 | 25 MG | Injection, fulvestrant | v1, posted March 1, 2022 |
| 1Q21 | $54.765 | – | 25 MG | Injection, fulvestrant | 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