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J1628 HCPCS Level II Code: Injection, guselkumab, 1 mg

Medicare Coverage & Payment

  • CMS short descriptor: Inj., guselkumab, 1 mg
  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Drugs (pricing indicator 51)
  • BETOS: O1E — Other drugs
  • Last CMS action effective: January 1, 2019

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Change history

  • January 1, 2019
    Added to the code set
    Injection, guselkumab, 1 mg

Related Codes

CMS cross-reference from deleted or non-Medicare codes

The CMS HCPCS Level II code set cross-references these codes (deleted or not valid for Medicare) to this code.

C9029 — Injection, guselkumab, 1 mg

Drug products (NDC)

CMS ASP NDC-HCPCS Crosswalk · 2026 Q3

Medicare Part B payment limit (ASP + 6%): $66.92

57894-0640-01 Tremfya — Janssen Biotech, Inc. (size 1 × qty 1 (1 MG per billing unit))

57894-0640-06 Tremfya — Janssen Biotech, Inc. (size 1 × qty 1 (1 MG per billing unit))

57894-0640-11 Tremfya — Janssen Biotech, Inc. (size 1 × qty 1 (1 MG per billing unit))

57894-0650-02 Tremfya — Janssen Biotech, Inc. (size 20 × qty 1 (1 MG per billing unit))

57894-0651-02 Tremfya — Janssen Biotech, Inc. (size 2 × qty 1 (1 MG per billing unit))

57894-0651-04 Tremfya — Janssen Biotech, Inc. (size 2 × qty 2 (1 MG per billing unit))

57894-0651-22 Tremfya — Janssen Biotech, Inc. (size 2 × qty 1 (1 MG per billing unit))

From the CMS ASP NDC-HCPCS Crosswalk and Part B Payment Limit File. Payment limits apply per HCPCS billing code, not per package.

Contextual Map

Every relationship of J1628 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes (21)

CMS cross-reference

Change history

  • January 1, 2019 — Added to the code set [Change history]

Nearest Codes in This Family

Official HCPCS Level II classifications closest to J1628 in its code family, with their registry titles.