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    HCPCS Details

    HCPC J3396
    Short Description Verteporfin injection
    Long Description Injection, verteporfin, 0.1 mg
    Pricing indicator 51
    Coverage code D
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 9
    Effective date 2005-01-01
    Date Added 2005-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00187560015 J3396 Verteporfin injection Visudyne BAUSCH HEALTH US LLC 0.1 MG 1 1 150 150
    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].

    Drug Details

    • Verteporfin injection is used in combination with photodynamic therapy (PDT; treatment with a laser light) to treat abnormal growth of leaky blood vessels in the eye caused by wet age-related macular degeneration (AMD; an ongoing disease of the eye that causes loss of the ability to see straight ahead and may make it more difficult to read, drive, or perform other daily activities), pathologic myopia (a serious form of nearsightedness that worsens with time), or histoplasmosis (a fungal infection) of the eye. Verteporfin is in a class of medications called photosensitizing agents. When verteporfin is activated by light, it closes up the leaking blood vessels.