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    HCPCS Details

    HCPC J2791
    Short Description Rhophylac injection
    Long Description Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu
    Pricing indicator 51
    Coverage code D
    ASC payment group code
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2016-01-01
    Date Added 2008-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    44206030001 J2791 Rhophylac injection Rhophylac CSL BEHRING LLC 100 UNITS 2 1 15 15
    44206030010 J2791 Rhophylac injection Rhophylac CSL BEHRING LLC 100 UNITS 2 10 15 150
    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 100 UNITS
    HCPCS/CPT Billing Units 0.01
    Total doses ordered
    Billing Units 0.01