Medicare’s limit for J9304 moves from $7.994 to $92.505 per 10 MG, the largest percent increase among the 879 codes compared with 3Q26.
Read the full record for J9304 →Most codes in the 4Q26 file (800 of 918) carry a 20% coinsurance. For these, CMS lists a lower, inflation-adjusted percentage. According to CMS, this happens when a Part B drug’s price rises faster than inflation (Medicare Inflation Rebate Program). The lowest:
All 84 drugs →The 4Q26 payment limit file (October–December 2026), posted by CMS on September 17, 2026, lists 918 HCPCS codes (1 without a payment limit). Compared with 3Q26, 367 codes went up, 433 went down and 79 did not change, and the median change was 0.0%. 38 codes are new this quarter and 10 were dropped.
The comparison covers the 879 codes that are in both quarters, have a payment limit in both, and kept the same billing unit. Left out: 1 with no payment limit in one of the quarters. The lead story and lists rank by percent change and skip codes under $1.00 last quarter.
