HCPCS drug code · CMS crosswalk
Ilaris J-Code / HCPCS Code
In short
Ilaris is billed under HCPCS J0638 — Injection, canakinumab, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 1 Ilaris NDC under this code.
Reference
- J0638
- Injection, canakinumab, 1 mgBilling unit: 1 mg
- Labelers
- Novartis Pharmaceuticals Corporation
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
Ilaris units and claim line
Enter the dose given to get the J0638 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Ilaris 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 |
|---|---|---|---|---|
| 00078-0734-61 | J0638 | Novartis Pharmaceuticals Corporation | 150 | 150 |
Ilaris: common questions
- What is the J-code for Ilaris?
- Ilaris is billed under HCPCS J0638 — Injection, canakinumab, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 1 Ilaris NDC under this code.
- How many J0638 billing units are in a package of Ilaris?
- CMS lists 150 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
- Is J0638 a CPT code?
- No. J0638 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.