HCPCS drug code · CMS crosswalk
Prolastin-C J-Code / HCPCS Code
In short
Prolastin-C is billed under HCPCS J0256 — Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Prolastin-C NDC under this code.
Reference
- J0256
- Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mgBilling unit: 10 mg
- Labelers
- Grifols USA, 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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Prolastin-C units and claim line
Enter the dose given to get the J0256 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Prolastin-C 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 |
|---|---|---|---|---|
| 13533-0705-01 | J0256 | Grifols USA, LLC | 1 | 0.1 |
Prolastin-C: common questions
- What is the J-code for Prolastin-C?
- Prolastin-C is billed under HCPCS J0256 — Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Prolastin-C NDC under this code.
- How many J0256 billing units are in a package of Prolastin-C?
- CMS lists 0.1 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is J0256 a CPT code?
- No. J0256 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.