In short

Leucovorin Calcium is billed under HCPCS J0643 — Injection, leucovorin calcium, not otherwise specified, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 35 Leucovorin Calcium NDCs under this code.

J0643 code details

Reference

J0643
Injection, leucovorin calcium, not otherwise specified, 1 mgBilling unit: 1 mg
Labelers
BluePoint Laboratories; FreseniUS Kabi USA, LLC; Glenmark Pharmaceuticals Inc., Usa; Hikma Pharmaceuticals USA Inc.; Meitheal Pharmaceuticals Inc.; Mylan Institutional LLC; Sagent Pharmaceuticals; Slate Run Pharmaceuticals

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$0.054
Per1 mg
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Added October 2026. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Leucovorin Calcium units and claim line

Enter the dose given to get the J0643 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Leucovorin Calcium 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.

Leucovorin Calcium NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
00143-9368-01J0643Hikma Pharmaceuticals USA Inc.1200
00143-9552-01J0643Hikma Pharmaceuticals USA Inc.1350
00143-9553-01J0643Hikma Pharmaceuticals USA Inc.1200
00143-9554-01J0643Hikma Pharmaceuticals USA Inc.1100
00143-9555-01J0643Hikma Pharmaceuticals USA Inc.150
25021-0813-10J0643Sagent Pharmaceuticals10 × 1500
25021-0814-30J0643Sagent Pharmaceuticals1100
25021-0815-30J0643Sagent Pharmaceuticals1200
25021-0816-30J0643Sagent Pharmaceuticals1350
25021-0816-67J0643Sagent Pharmaceuticals1350
25021-0828-50J0643Sagent Pharmaceuticals1500
63323-0631-10J0643FreseniUS Kabi USA, LLC10100
63323-0631-50J0643FreseniUS Kabi USA, LLC50500
63323-0710-50J0643FreseniUS Kabi USA, LLC1200
63323-0711-00J0643FreseniUS Kabi USA, LLC1500
67457-0528-10J0643Mylan Institutional LLC1100
67457-0529-20J0643Mylan Institutional LLC1200
67457-0530-35J0643Mylan Institutional LLC1350
68001-0416-36J0643BluePoint Laboratories1100
68001-0417-37J0643BluePoint Laboratories1200
68001-0418-38J0643BluePoint Laboratories1350
68001-0648-36J0643BluePoint Laboratories1100
68001-0649-37J0643BluePoint Laboratories1200
68001-0650-38J0643BluePoint Laboratories1350
68462-0767-35J0643Glenmark Pharmaceuticals Inc., Usa1350
70436-0116-82J0643Slate Run Pharmaceuticals10 × 1500
70436-0117-80J0643Slate Run Pharmaceuticals1100
70436-0118-80J0643Slate Run Pharmaceuticals1200
70436-0119-80J0643Slate Run Pharmaceuticals1350
70436-0120-80J0643Slate Run Pharmaceuticals1500
71288-0160-10J0643Meitheal Pharmaceuticals Inc.150
71288-0161-20J0643Meitheal Pharmaceuticals Inc.1100
71288-0162-30J0643Meitheal Pharmaceuticals Inc.1200
71288-0163-30J0643Meitheal Pharmaceuticals Inc.1350
71288-0164-50J0643Meitheal Pharmaceuticals Inc.1500

Leucovorin Calcium: common questions

What is the J-code for Leucovorin Calcium?
Leucovorin Calcium is billed under HCPCS J0643 — Injection, leucovorin calcium, not otherwise specified, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 35 Leucovorin Calcium NDCs under this code.
How many J0643 billing units are in a package of Leucovorin Calcium?
CMS lists 50 to 500 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 J0643 a CPT code?
No. J0643 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.

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