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    HCPCS Details

    HCPC J1303
    Short Description Inj., ravulizumab-cwvz 10 mg
    Long Description Injection, ravulizumab-cwvz, 10 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2019-10-01
    Date Added 2019-10-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    25682002201 J1303 Inj., ravulizumab-cwvz 10 mg Ultomiris ALEXION PHARMACEUTICALS 10 MG 30 1 30 30
    25682002501 J1303 Inj., ravulizumab-cwvz 10 mg Ultomiris ALEXION PHARMACEUTICALS 10 MG 3 1 30 30
    25682002801 J1303 Inj., ravulizumab-cwvz 10 mg Ultomiris ALEXION PHARMACEUTICALS 10 MG 11 1 110 110
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 10 MG
    HCPCS/CPT Billing Units 0.1
    Total doses ordered
    Billing Units 0.1

    Drug Details

    • Ravulizumab-cwvz injection is used in adults and children 1 month of age and older to treat paroxysmal nocturnal hemoglobinuria (PNH: a type of anemia in which too many red blood cells are broken down in the body, so there are not enough healthy cells to bring oxygen to all parts of the body). Ravulizumab-cwvz injection is also used in adults and children 1 month of age and older to treat atypical hemolytic uremic syndrome (aHUS; an inherited condition in which small blood clots form in the body and may cause damage to the blood vessels, blood cells, kidneys, and other parts of the body). Ravulizumab-cwvz injection is also used in adults to treat a certain form of myasthenia gravis (MG; a disorder of the nervous system that causes muscle weakness). Ravulizumab-cwvz is in a class of medications called monoclonal antibodies. It works by blocking the activity of the part of the immune system that may damage blood cells in people with PNH and that causes clots to form in people with aHUS. It works by disrupting communication between nerves and muscles in people with MG.