J0791 HCPCS Level II Code: Injection, crizanlizumab-tmca, 5 mg
Coding at a Glance
- Drug products
- 1 NDC product
- CMS cross-references
- 1 related code
Medicare Coverage & Payment
- CMS short descriptor: Inj crizanlizumab-tmca 5mg
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Payment category: Drugs (pricing indicator 51)
- BETOS: O1E — Other drugs
- Last CMS action effective: July 1, 2020
Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.
Change history
- July 1, 2020Added to the code setInjection, crizanlizumab-tmca, 5 mg
Related Codes
CMS cross-reference from deleted or non-Medicare codes
The CMS HCPCS Level II code set cross-references these codes (deleted or not valid for Medicare) to this code.
Drug products (NDC)
CMS ASP NDC-HCPCS Crosswalk · 2026 Q3
Medicare Part B payment limit (ASP + 6%): $129.94
From the CMS ASP NDC-HCPCS Crosswalk and Part B Payment Limit File. Payment limits apply per HCPCS billing code, not per package.
Contextual Map
Every relationship of J0791 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Nearest codes (34)
- J0701 — Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg[Sibling]
- J0702 — Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg[Sibling]
- J0703 — Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg[Sibling]
- J0706 — Injection, caffeine citrate, 5 mg[Sibling]
- J0710 — Injection, cephapirin sodium, up to 1 gm[Sibling]
- J0712 — Injection, ceftaroline fosamil, 10 mg[Sibling]
- J0713 — Injection, ceftazidime, per 500 mg[Sibling]
- J0714 — Injection, ceftazidime and avibactam, 0.5 g/0.125 g[Sibling]
- and 26 more
CMS cross-reference
- C9053 — Injection, crizanlizumab-tmca, 1 mg[Cross-referenced from]
Change history
- July 1, 2020 — Added to the code set [Change history]
Nearest Codes in This Family
Official HCPCS Level II classifications closest to J0791 in its code family, with their registry titles.
- J0750 — Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
- J0751 — Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)
- J0752 — Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
- J0759 — Injection, clevidipine butyrate, 1 mg
- J0760 — Injection, colchicine, per 1 mg
- J0770 — Injection, colistimethate sodium, up to 150 mg
- J0775 — Injection, collagenase, clostridium histolyticum, 0.01 mg
- J0780 — Injection, prochlorperazine, up to 10 mg
- J0795 — Injection, corticorelin ovine triflutate, 1 microgram
- J0799 — Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified