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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, 2024
    Added to the code set
    Injection, 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)

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.