J1203 HCPCS Level II Code: Injection, cipaglucosidase alfa-atga, 5 mg
Coding at a Glance
- Drug products
- 1 NDC product
Medicare Coverage & Payment
- CMS short descriptor: Inj, cipaglucosidase, 5 mg
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Payment category: Drugs (pricing indicator 51)
- BETOS: O1E — Other drugs
- Last CMS action effective: April 1, 2024
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
- April 1, 2024Added to the code setInjection, cipaglucosidase alfa-atga, 5 mg
Drug products (NDC)
CMS ASP NDC-HCPCS Crosswalk · 2026 Q3
Medicare Part B payment limit (ASP + 6%): $96.30
71904-0200-01 — Pombiliti — Amicus Therapeutics US, LLC (size 1 × qty 1 (5 MG per billing unit))
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 J1203 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 (17)
- J1200 — Injection, diphenhydramine hcl, up to 50 mg[Sibling]
- J1201 — Injection, cetirizine hydrochloride, 0.5 mg[Sibling]
- J1202 — Miglustat, oral, 65 mg[Sibling]
- J1205 — Injection, chlorothiazide sodium, per 500 mg[Sibling]
- J1212 — Injection, dmso, dimethyl sulfoxide, 50%, 50 ml[Sibling]
- J1230 — Injection, methadone hcl, up to 10 mg[Sibling]
- J1240 — Injection, dimenhydrinate, up to 50 mg[Sibling]
- J1245 — Injection, dipyridamole, per 10 mg[Sibling]
- and 9 more
Change history
- April 1, 2024 — Added to the code set [Change history]
Nearest Codes in This Family
Official HCPCS Level II classifications closest to J1203 in its code family, with their registry titles.
- J1200 — Injection, diphenhydramine hcl, up to 50 mg
- J1201 — Injection, cetirizine hydrochloride, 0.5 mg
- J1202 — Miglustat, oral, 65 mg
- J1205 — Injection, chlorothiazide sodium, per 500 mg
- J1212 — Injection, dmso, dimethyl sulfoxide, 50%, 50 ml
- J1230 — Injection, methadone hcl, up to 10 mg
- J1240 — Injection, dimenhydrinate, up to 50 mg
- J1245 — Injection, dipyridamole, per 10 mg
- J1250 — Injection, dobutamine hydrochloride, per 250 mg
- J1260 — Injection, dolasetron mesylate, 10 mg