`J2010` Lincomycin injection

Injection, lincomycin hcl, up to 300 mg

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 10 units per day (clinical), rationale: Clinical: Data
Outpatient hospital: max 10 units per day (clinical), rationale: Clinical: Data
DME supplier: max 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for J2010

Medicare Part B drug payment limit (ASP, October 2026)

J2010 payment limit: $3.69 per 300 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J2010 (CMS ASP NDC-HCPCS crosswalk, October 2026)

00009-0104-04 Lincocin, Pfizer Inc: 2 billing units per package (1 VIAL in 1 CARTON / 2 mL in 1 VIAL)
00009-0107-04 Lincocin, Pfizer Inc: 10 billing units per package (1 VIAL in 1 CARTON / 10 mL in 1 VIAL)
00009-0555-01 Lincocin, Pfizer Inc: 2 billing units per package
39822-0350-02 Lincocin, XGen Pharmaceuticals DJB, Inc.: 20 billing units per package (10 VIAL in 1 CARTON / 2 mL in 1 VIAL)
39822-0353-06 Lincocin, XGen Pharmaceuticals DJB, Inc.: 100 billing units per package (10 mL in 1 VIAL)
72485-0114-01 Lincomycin, Armas Pharmaceuticals Inc.: 2 billing units per package (1 VIAL, MULTI-DOSE in 1 CARTON / 2 mL in 1 VIAL, MULTI-DOSE)
72485-0115-10 Lincomycin, Armas Pharmaceuticals Inc.: 100 billing units per package (10 VIAL, MULTI-DOSE in 1 CARTON / 10 mL in 1 VIAL, MULTI-DOSE)
00404-9901-10 Lincomycin, Henry Schein Inc.: 10 billing units per package (1 VIAL in 1 BAG / 10 mL in 1 VIAL)
50090-4533-00 Lincomycin HCl, A-S Medication Solutions: 10 billing units per package
00121-1035-55 Lincomycin HCl, PAI Holdings, LLC: 100 billing units per package (10 VIAL, MULTI-DOSE in 1 CARTON / 10 mL in 1 VIAL, MULTI-DOSE)
25021-0193-02 Lincomycin HCl, Sagent Pharmaceuticals: 20 billing units per package (10 VIAL in 1 CARTON / 2 mL in 1 VIAL)
25021-0193-10 Lincomycin HCl, Sagent Pharmaceuticals: 100 billing units per package (10 VIAL in 1 CARTON / 10 mL in 1 VIAL)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J2010

Payer coverage policies that name J2010

J2010 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Injectable Medications (0020)	listed, no stance (range J0278-J2543)	Mar 5, 2026	payer document

Medicaid fee-for-service

AZ: $4.23 (outpatient_hospital), effective Jul 1, 2026
FL: $10.00 (physician_administered_drugs), effective Jan 1, 2026
IL: $4.71 (practitioner), effective Apr 1, 2026
IN: $3.57 (professional, Advanced Practice Nurse (85%), non-facility), effective Oct 1, 2024
KS: $3.69 (default), effective Oct 1, 2026
KY: $0.00 (asc), effective Jan 1, 2026
LA: $4.23 (professional), effective Jul 1, 2026
MS: $4.72 (comprehensive), effective Jul 1, 2026
NE: $4.23 (injectables), effective Jul 1, 2026
OH: $4.23 (provider_administered_drugs), effective Jul 1, 2026
OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
TX: $5.40 (healthy_texas_women, Clinic/Group Practice, non-facility), effective Sep 1, 2026
VA: $4.23 (medical), effective Jul 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $4.23 (professional_administered_drugs), effective Jul 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

J2010 Lincomycin injection