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    HCPCS Details

    HCPC J2788
    Short Description Rho d immune globulin 50 mcg
    Long Description Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)
    Pricing indicator 51
    Coverage code D
    ASC payment group code
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2014-01-01
    Date Added 2003-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00562780601 J2788 Rho d immune globulin 50 mcg MICRhoGAM KEDRION BIOPHARMA, INC. 50 MCG (250 IU) 1 1 1 1
    00562780605 J2788 Rho d immune globulin 50 mcg MICRhoGAM UF Plus KEDRION BIOPHARMA, INC. 50 MCG (250 IU) 1 5 1 5
    00562780625 J2788 Rho d immune globulin 50 mcg MICRhoGAM UF Plus KEDRION BIOPHARMA, INC. 50 MCG (250 IU) 1 25 1 25
    13533066106 J2788 Rho d immune globulin 50 mcg HYPERRHO S/D GRIFOLS USA, LLC 50 MCG 1 10 1 10
    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 50 MCG
    HCPCS/CPT Billing Units 0.02
    Total doses ordered
    Billing Units 0.02