J0875 – Injection, dalbavancin, 5 mg
HCPCS Level II code · J codes: Drugs Administered Other Than Oral Method
HCPCS codeJ0875
- Long description
- Injection, dalbavancin, 5 mg
- Short description
- Injection, dalbavancin
- Pricing indicator
51Drugs- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
O1EOther drugs- ASC
- Approved for ambulatory surgical centers
- Added
- January 1, 2016
- Last change
- January 1, 2016 – No change
Frequently asked questions
What is HCPCS code J0875?
J0875 is a HCPCS Level II code for injection, dalbavancin, 5 mg.
Does Medicare cover J0875?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby J codes
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- J0870 – Injection, imetelstat, 1 mg
- J0871 – Injection, daptomycin (endo), not therapeutically equivalent to j0878, 1 mg
- J0872 – Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg
- J0873 – Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg
- J0874 – Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg
- J0877 – Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
- J0878 – Injection, daptomycin, 1 mg
- J0879 – Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)
- J0881 – Injection, darbepoetin alfa, 1 microgram (non-esrd use)
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- J0883 – Injection, argatroban, 1 mg (for non-esrd use)
- J0884 – Injection, argatroban, 1 mg (for esrd on dialysis)
- J0885 – Injection, epoetin alfa, (for non-esrd use), 1000 units
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.