Home › Drug Codes › J Codes › J0490 · BENLYSTA
Updated July 1st, 2026

BENLYSTA J Code: J0490

Injection, belimumab, 10 mg

Login to unlock all benchmarks

Q4 2026 Medicare Payment Limit for J0490, effective October 1, 2026: $58.333 per HCPCS billing unit, up 0.1% from $58.296. From CMS's final file.

?
Medicare Payment Limit ?
$58.296
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$58.296
/ HCPCS billing unit · APC 1353
ASP ?
$•••.••
Login to view
WAC · AWP ?
$•••.••
Login to view
NDCs Crosswalked ?
2
View NDC crosswalk →
Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list J0490 as usually self-administered and exclude it from Part B coverage in their jurisdictions. Check the article for your MAC before billing: CGS, First Coast, Noridian (A53032), Noridian (A53033), Novitas, Palmetto, Wellpoint Federal, WPS · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, belimumab, 10 mg
HCPCS Added Date January 1, 2012
Manufacturer Glaxo Smithkline Pharmaceuticals
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Powder, Lyophilized, For Solution

About BENLYSTA

Benlysta is a medication aligned to the HCPCS J Code: J0490 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology drug administered via the intravenous route and manufactured by Glaxo Smithkline Pharmaceuticals.

According to CMS Drug Use Information: This medication is used with other medications to treat certain types of lupus. Belimumab belongs to a class of drugs known as monoclonal antibodies. It works by decreasing the effect of a certain protein that is increased in people with active lupus. This may help decrease some of the symptoms of lupus.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
49401-0101-01 Benlysta GlaxoSmithKline LLC 12 120 MG / 1.5 ML
49401-0102-01 Benlysta GlaxoSmithKline LLC 40 400 MG / 5 ML
Login for the full NDC crosswalk View pricing, complete NDC-to-HCPCS alignments, and package details.
Login →

BENLYSTA Pricing & Reimbursement

J0490 Private Payer Reimbursement
$57.12 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →
UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

BENLYSTA Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 18.52%
Avg. Days to File 8.6days
Avg. Days to Pay 23.0days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J0490 claims analytics on FocalPoint →
OnPoint Oncology

BENLYSTA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Benlysta (J0490) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

BENLYSTA Medically Unlikely Edits (MUE)

The most billing units of J0490 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient
160 units / day
= 1,600 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

BENLYSTA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Active SLE Active lupus nephritis
Drug Class
B Lymphocyte Stimulator-directed Antibody Interactions [MoA]B Lymphocyte Stimulator-specific Inhibitor [EPC]Decreased B Lymphocyte Activation [PE]

Login for BuyandBill.com Analytics

Unlock deeper insights with BuyandBill’s Comparative Report!

  • Compare ASP, WAC, and AWP across drugs.
  • Visualize Drug Price Movement Over Time
  • Tailor reports to drug class, manufacturer, or HCPCS Code.
  • Compare Biosimilar and 505(b)(2) products.
Access Full Report →

Frequently Asked Questions

Is there an available Benlysta billing and coding guide?
Billing and coding information for BENLYSTA can be found through GSK. Visit Here →
Are there any available Benlysta patient assistance programs?
BENLYSTA patient assistance information can be found through GSK. Visit Here →
Where can I find Benlysta prescribing information?
BENLYSTA prescribing information can be found at the link below: Visit Here →
Where can I find Benlysta side effect information?
Information regarding BENLYSTA's side effects can be found at MedlinePlus Visit Here →
Does billing BENLYSTA require JZ/JW wastage modifiers?
CMS has identified BENLYSTA(J0490) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.

Related Drug Codes

Explore billing, coding, and pricing for drugs related to BENLYSTA.

C9149TZIELDInjection, teplizumab-mzwv, 5 mcgProvention BioAdded April 1, 2023C9166COSENTYXInjection, secukinumab, intravenous, 1 mgNovartisAdded April 1, 2024C9305IMAAVYInjection, nipocalimab-aahu, 3 mgJanssenAdded October 1, 2025J0215ALEFACEPTInjection, alefacept, 0.5 mgAdded January 1, 2004J0491SaphneloInjection, anifrolumab-fnia, 1 mgMultiple ManufacturersAdded April 1, 2022J0593TAKHZYROInjection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)Takeda PharmaceuticalsAdded October 1, 2019J0596RUCONESTInjection, c1 esterase inhibitor (recombinant), ruconest, 10 unitsPharming HealthcareAdded January 1, 2016J0597BERINERTInjection, c-1 esterase inhibitor (human), berinert, 10 unitsCSL BehringAdded January 1, 2011J0598CINRYZEInjection, c-1 esterase inhibitor (human), cinryze, 10 unitsTakeda PharmaceuticalsAdded January 1, 2010J0599HAEGARDAInjection, c-1 esterase inhibitor (human), (haegarda), 10 unitsCSL BehringAdded January 1, 2019