Quarter-over-quarter movers
The 25 largest increases and 25 largest decreases in payment limit. Only the 879 codes with a payment limit in both quarters and the same billing unit are compared.
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Codes with a 3Q26 payment limit under $1.00 are left out of this ranking, because a change of a few cents on a small amount looks like a very large percent (152 codes that changed are left out). They are still in the dollar ranking.
Largest increases by percent change
| Code | Drug | Billing unit | 3Q26 | 4Q26 | % change | Change | 8 quarters |
|---|---|---|---|---|---|---|---|
| J9304 | Inj. pemetrexed, 10 mg | 10 MG | $7.994 | $92.505 | ↑ 1057.2% | +$84.511 | |
| J3489 | Zoledronic acid 1mg | 1 MG | $3.361 | $17.673 | ↑ 425.8% | +$14.312 | |
| Q5120 | Inj pegfilgrastim-bmez 0.5mg | 0.5 MG | $132.096 | $302.247 | ↑ 128.8% | +$170.151 | |
| Q5112 | Inj ontruzant 10 mg | 10 MG | $20.989 | $32.791 | ↑ 56.2% | +$11.802 | |
| J2175 | Meperidine hydrochl /100 mg | 100 MG | $6.339 | $9.652 | ↑ 52.3% | +$3.313 | |
| J2596 | Vasopressin (long grove) 1 u | 1 UNIT | $1.134 | $1.712 | ↑ 51.0% | +$0.578 | |
| J2562 | Plerixafor injection | 1 MG | $28.489 | $42.943 | ↑ 50.7% | +$14.454 | |
| J1598 | Inj glycopyrrolate fres kabi | 0.1 MG | $1.342 | $1.904 | ↑ 41.9% | +$0.562 | |
| J0500 | Dicyclomine injection | 20 MG | $8.52 | $12.061 | ↑ 41.6% | +$3.541 | |
| J2506 | Inj pegfilgrast ex bio 0.5mg | 0.5 MG | $143.233 | $201.241 | ↑ 40.5% | +$58.008 | |
| J7329 | Inj, trivisc 1 mg | 1 MG | $3.036 | $4.207 | ↑ 38.6% | +$1.171 | |
| 91320 | SARSCV2 VAC 30MCG TRS-SUC IM | 0.3 ML | $168.367 | $230.405 | ↑ 36.8% | +$62.038 | |
| J0456 | Azithromycin | 500 MG | $1.889 | $2.571 | ↑ 36.1% | +$0.682 | |
| 90661 | CCIIV3 VACCINE NO PRSC 0.5ML IM | 0.5 ML | $49.495 | $66.569 | ↑ 34.5% | +$17.074 | |
| J1956 | Levofloxacin injection | 250 MG | $1.909 | $2.565 | ↑ 34.4% | +$0.656 | |
| J2690 | Procainamide hcl injection | 1 GM | $295.361 | $394.868 | ↑ 33.7% | +$99.507 | |
| J2601 | Inj, vasopressin (baxter) | 1 UNIT | $1.753 | $2.328 | ↑ 32.8% | +$0.575 | |
| J2805 | Sincalide injection | 5 MCG | $110.462 | $145.638 | ↑ 31.8% | +$35.176 | |
| J1643 | Inj heparin, pfizer, 1000u | 1000 UNITS | $1.711 | $2.248 | ↑ 31.4% | +$0.537 | |
| J0650 | Inj, levothyroxine nos 10mcg | 10 MCG | $5.096 | $6.581 | ↑ 29.1% | +$1.485 | |
| J9041 | Injection, bortezomib, 0.1mg | 0.1 MG | $2.037 | $2.628 | ↑ 29.0% | +$0.591 | |
| J0694 | Cefoxitin sodium injection | 1 GM | $4.285 | $5.416 | ↑ 26.4% | +$1.131 | |
| J7060 | 5% dextrose/water | 500 ML | $1.649 | $2.082 | ↑ 26.3% | +$0.433 | |
| J9294 | Inj pemetrexed, hospira 10mg | 10 MG | $2.943 | $3.678 | ↑ 25.0% | +$0.735 | |
| 91323 | SARSCOV2 VAC 10 MCG/0.2ML IM | 10 MCG | $201.913 | $252.225 | ↑ 24.9% | +$50.312 |
Largest decreases by percent change
| Code | Drug | Billing unit | 3Q26 | 4Q26 | % change | Change | 8 quarters |
|---|---|---|---|---|---|---|---|
| J9305 | Inj. pemetrexed nos 10mg | 10 MG | $6.952 | $1.23 | ↓ 82.3% | −$5.722 | |
| J3105 | Terbutaline sulfate inj | 1 MG | $2.82 | $1.00 | ↓ 64.5% | −$1.82 | |
| Q5119 | Inj ruxience, 10 mg | 10 MG | $16.16 | $5.792 | ↓ 64.2% | −$10.368 | |
| J2778 | Ranibizumab injection | 0.1 mg | $51.09 | $26.384 | ↓ 48.4% | −$24.706 | |
| J9264 | Paclitaxel protein bound | 1 MG | $6.586 | $3.64 | ↓ 44.7% | −$2.946 | |
| J3000 | Streptomycin injection | 1 GM | $26.883 | $16.407 | ↓ 39.0% | −$10.476 | |
| J9033 | Inj, bendamustine (nos) 1mg | 1 MG | $2.96 | $1.846 | ↓ 37.6% | −$1.114 | |
| J9261 | Nelarabine injection | 50 MG | $65.407 | $40.872 | ↓ 37.5% | −$24.535 | |
| J9293 | Mitoxantrone hydrochl / 5 mg | 5 MG | $29.702 | $19.418 | ↓ 34.6% | −$10.284 | |
| J1790 | Droperidol injection | up to 5 MG | $8.124 | $5.348 | ↓ 34.2% | −$2.776 | |
| Q5156 | Inj, tocilizumab-anoh, 1 mg | 1 MG | $4.692 | $3.098 | ↓ 34.0% | −$1.594 | |
| J1560 | Gamma globulin > 10 cc inj | 10 CC | $162.519 | $118.153 | ↓ 27.3% | −$44.366 | |
| J3360 | Diazepam injection | 5 MG | $6.854 | $5.069 | ↓ 26.0% | −$1.785 | |
| J1190 | Dexrazoxane hcl injection | 250 MG | $41.441 | $30.832 | ↓ 25.6% | −$10.609 | |
| J9351 | Topotecan injection | 0.1 MG | $2.759 | $2.067 | ↓ 25.1% | −$0.692 | |
| J9017 | Arsenic trioxide injection | 1 MG | $5.069 | $3.837 | ↓ 24.3% | −$1.232 | |
| J1811 | Fiasp for insulin pump use | 50 UNITS | $1.526 | $1.181 | ↓ 22.6% | −$0.345 | |
| J0561 | Penicillin g benzathine inj | 100,000 UNITS | $32.592 | $25.612 | ↓ 21.4% | −$6.98 | |
| J9036 | Inj. belrapzo/bendamustine | 1 MG | $11.599 | $9.264 | ↓ 20.1% | −$2.335 | |
| Q5098 | Inj ustekinumab-srlf, 1 mg | 1 MG | $11.551 | $9.27 | ↓ 19.7% | −$2.281 | |
| J1455 | Foscarnet sodium injection | 1000 MG | $8.355 | $6.734 | ↓ 19.4% | −$1.621 | |
| J2360 | Orphenadrine injection | 60 MG | $7.777 | $6.274 | ↓ 19.3% | −$1.503 | |
| J0594 | Busulfan injection | 1 MG | $1.033 | $0.839 | ↓ 18.8% | −$0.194 | |
| J1813 | Lyumjev for insulin pump use | 50 UNITS | $4.802 | $3.903 | ↓ 18.7% | −$0.899 | |
| J1265 | Dopamine injection | 40 MG | $1.012 | $0.823 | ↓ 18.7% | −$0.189 |
Largest increases by dollar change
| Code | Drug | Billing unit | 3Q26 | 4Q26 | Change | % change | 8 quarters |
|---|---|---|---|---|---|---|---|
| Q2053 | Brexucabtagene car pos t | UP TO 200 MILLION AUTOLOGOUS ANTI-CD19 CAR POSITIVE VIABLE T CELLS | $510,103.919 | $532,352.741 | +$22,248.822 | +4.4% | |
| Q2041 | Axicabtagene ciloleucel car+ | UP TO 200 MILLION CAR T CELLS | $562,500.892 | $577,943.258 | +$15,442.366 | +2.7% | |
| Q2042 | Tisagenlecleucel car-pos t | up to 600 million CAR-positive viable T cells | $611,693.171 | $626,315.834 | +$14,622.663 | +2.4% | |
| Q2054 | Lisocabtagene mara car pos t | Up to 110 million CAR-positive viable T cells, per therapeutic dose | $579,570.614 | $589,846.771 | +$10,276.157 | +1.8% | |
| Q2055 | Idecabtagene vicleucel car | UP TO 510 MILLION AUTOLOGOUS ANTI-BCMA CAR-POSITIVE VIABLE T CELLS | $567,977.78 | $575,850.465 | +$7,872.685 | +1.4% | |
| Q2056 | Ciltacabtagene car-pos t | up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells | $587,977.755 | $594,112.255 | +$6,134.50 | +1.0% | |
| J9029 | Instill adstiladrin, tx dose | PER THERAPEUTIC DOSE | $64,331.614 | $65,200.563 | +$868.949 | +1.4% | |
| Q0224 | Inj, pemivibart, 4500 mg | 4500 MG | $7,239.00 | $7,615.20 | +$376.20 | +5.2% | |
| J9226 | Supprelin la implant | 50 MG | $37,491.974 | $37,837.548 | +$345.574 | +0.9% | |
| J1162 | Digoxin immune fab (ovine) | PER VIAL | $5,383.321 | $5,711.373 | +$328.052 | +6.1% | |
| J9266 | Pegaspargase injection | 1 EA | $29,663.965 | $29,845.265 | +$181.30 | +0.6% | |
| Q5120 | Inj pegfilgrastim-bmez 0.5mg | 0.5 MG | $132.096 | $302.247 | +$170.151 | +128.8% | |
| J0840 | Crotalidae poly immune fab | UP TO 1 GM | $1,906.906 | $2,044.383 | +$137.477 | +7.2% | |
| J2690 | Procainamide hcl injection | 1 GM | $295.361 | $394.868 | +$99.507 | +33.7% | |
| J9304 | Inj. pemetrexed, 10 mg | 10 MG | $7.994 | $92.505 | +$84.511 | +1057.2% | |
| J0600 | Edetate calcium disodium inj | 1000 MG | $6,189.487 | $6,273.865 | +$84.378 | +1.4% | |
| J2507 | Pegloticase injection | 1 MG | $3,929.337 | $4,000.629 | +$71.292 | +1.8% | |
| J9183 | Gemcitabine intravesical sys | 225 MG | $72,984.241 | $73,054.053 | +$69.812 | +0.1% | |
| 91320 | SARSCV2 VAC 30MCG TRS-SUC IM | 0.3 ML | $168.367 | $230.405 | +$62.038 | +36.8% | |
| J7327 | Monovisc inj per dose | PER DOSE | $565.275 | $626.144 | +$60.869 | +10.8% | |
| J2506 | Inj pegfilgrast ex bio 0.5mg | 0.5 MG | $143.233 | $201.241 | +$58.008 | +40.5% | |
| 91323 | SARSCOV2 VAC 10 MCG/0.2ML IM | 10 MCG | $201.913 | $252.225 | +$50.312 | +24.9% | |
| 91304 | SARSCOV2 VAC 5MCG/0.5ML IM | 0.5 ML | $191.919 | $232.218 | +$40.299 | +21.0% | |
| J2805 | Sincalide injection | 5 MCG | $110.462 | $145.638 | +$35.176 | +31.8% | |
| J9217 | Leuprolide acetate suspnsion | 7.5 MG | $160.342 | $188.849 | +$28.507 | +17.8% |
Largest decreases by dollar change
| Code | Drug | Billing unit | 3Q26 | 4Q26 | Change | % change | 8 quarters |
|---|---|---|---|---|---|---|---|
| J3402 | Inj. remestemcel-l-rknd/ td | Per Therapeutic Dose | $203,659.763 | $202,159.938 | −$1,499.825 | −0.7% | |
| Q2043 | Sipuleucel-t auto cd54+ | Per infusion (minimum 50 million cells) | $55,932.427 | $55,663.131 | −$269.296 | −0.5% | |
| J0801 | Inj. acthar gel to 40 units | 40 UNITS | $4,133.449 | $3,884.267 | −$249.182 | −6.0% | |
| J9268 | Pentostatin injection | 10 MG | $2,697.987 | $2,612.893 | −$85.094 | −3.2% | |
| J1560 | Gamma globulin > 10 cc inj | 10 CC | $162.519 | $118.153 | −$44.366 | −27.3% | |
| J9050 | Carmustine injection | 100 MG | $240.011 | $195.73 | −$44.281 | −18.4% | |
| J1950 | Leuprolide acetate /3.75 mg | 3.75 MG | $1,841.261 | $1,799.052 | −$42.209 | −2.3% | |
| J7504 | Lymphocyte immune globulin | 250 MG | $5,548.962 | $5,509.072 | −$39.89 | −0.7% | |
| Q5147 | Inj, aflibercept-ayyh, 1 mg | 1 MG | $803.255 | $763.376 | −$39.879 | −5.0% | |
| J0202 | Injection, alemtuzumab | 1 MG | $2,544.937 | $2,506.20 | −$38.737 | −1.5% | |
| J9185 | Fludarabine phosphate inj | 50 MG | $206.299 | $177.924 | −$28.375 | −13.8% | |
| J0802 | Inj. (ani), up to 40 units | up to 40 Units | $3,674.678 | $3,646.455 | −$28.223 | −0.8% | |
| J7525 | Tacrolimus injection | 5 MG | $268.176 | $242.073 | −$26.103 | −9.7% | |
| J2778 | Ranibizumab injection | 0.1 mg | $51.09 | $26.384 | −$24.706 | −48.4% | |
| J9261 | Nelarabine injection | 50 MG | $65.407 | $40.872 | −$24.535 | −37.5% | |
| J1454 | Inj fosnetupitant, palonoset | 0.25 MG | $503.848 | $479.902 | −$23.946 | −4.8% | |
| J0178 | Aflibercept injection | 1 MG | $743.605 | $722.251 | −$21.354 | −2.9% | |
| Q5111 | Injection, udenyca 0.5 mg | 0.5 MG | $149.133 | $128.967 | −$20.166 | −13.5% | |
| Q2050 | Doxorubicin inj 10mg | 10 MG | $116.605 | $97.823 | −$18.782 | −16.1% | |
| J8655 | Oral netupitant, palonosetro | 0.5 MG | $474.038 | $455.762 | −$18.276 | −3.9% | |
| J9357 | Valrubicin injection | 200 MG | $1,247.047 | $1,230.664 | −$16.383 | −1.3% | |
| J9245 | Inj melpha hydroch nos 50 mg | 50 MG | $104.898 | $90.032 | −$14.866 | −14.2% | |
| J1205 | Chlorothiazide sodium inj | 500 MG | $77.771 | $63.398 | −$14.373 | −18.5% | |
| J2781 | Inj, pegcetacoplan, 1mg | 1 MG | $148.944 | $135.267 | −$13.677 | −9.2% | |
| J1430 | Ethanolamine oleate 100 mg | 100 MG | $547.271 | $533.768 | −$13.503 | −2.5% |
The trend lines show each code’s payment limit for the last 8 quarters, with a dot on 4Q26. Gaps are quarters with no limit or a different billing unit.