HCPCS drug code · CMS crosswalk
Pombiliti J-Code / HCPCS Code
In short
Pombiliti is billed under HCPCS J1203 — Injection, cipaglucosidase alfa-atga, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 1 Pombiliti NDC under this code.
Reference
- J1203
- Injection, cipaglucosidase alfa-atga, 5 mgBilling unit: 5 mg
- Labelers
- Amicus Therapeutics US, LLC
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Inflation-adjusted coinsurance. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Pombiliti units and claim line
Enter the dose given to get the J1203 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Pombiliti NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 71904-0200-01 | J1203 | Amicus Therapeutics US, LLC | 1 | 21 |
Pombiliti: common questions
- What is the J-code for Pombiliti?
- Pombiliti is billed under HCPCS J1203 — Injection, cipaglucosidase alfa-atga, 5 mg. One billing unit is 5 mg. CMS's crosswalk lists 1 Pombiliti NDC under this code.
- How many J1203 billing units are in a package of Pombiliti?
- CMS lists 21 billing units per package, depending on the NDC, where one unit is 5 mg. Units to report are based on the dose given, not the package.
- Is J1203 a CPT code?
- No. J1203 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.