HCPCS Level II · unclassified
J0643 — Injection, leucovorin calcium, not otherwise specified, 1 mg
In short
J0643 is the HCPCS Level II code for injection, leucovorin calcium, not otherwise specified, 1 mg: drugs with no specific code of their own. It has no fixed drug or unit, so the claim carries the NDC of the drug given and its quantity.
Code
CMS HCPCS file- Descriptor
- Injection, leucovorin calcium, not otherwise specified, 1 mg
- Short descriptor
- Inj leucovorin calcium 1 mg
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Oct 1, 2026
The billing unit is read from the descriptor. Confirm it against the CMS file before billing.
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: Added October 2026. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Units and claim line
Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
NDCs billed under J0643
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 35 NDCs to J0643 for Leucovorin Calcium. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Leucovorin Calcium | 00143-9368-01 | Hikma Pharmaceuticals USA Inc. | 1 | 200 |
| Leucovorin Calcium | 00143-9552-01 | Hikma Pharmaceuticals USA Inc. | 1 | 350 |
| Leucovorin Calcium | 00143-9553-01 | Hikma Pharmaceuticals USA Inc. | 1 | 200 |
| Leucovorin Calcium | 00143-9554-01 | Hikma Pharmaceuticals USA Inc. | 1 | 100 |
| Leucovorin Calcium | 00143-9555-01 | Hikma Pharmaceuticals USA Inc. | 1 | 50 |
| Leucovorin Calcium | 25021-0813-10 | Sagent Pharmaceuticals | 10 × 1 | 500 |
| Leucovorin Calcium | 25021-0814-30 | Sagent Pharmaceuticals | 1 | 100 |
| Leucovorin Calcium | 25021-0815-30 | Sagent Pharmaceuticals | 1 | 200 |
| Leucovorin Calcium | 25021-0816-30 | Sagent Pharmaceuticals | 1 | 350 |
| Leucovorin Calcium | 25021-0816-67 | Sagent Pharmaceuticals | 1 | 350 |
| Leucovorin Calcium | 25021-0828-50 | Sagent Pharmaceuticals | 1 | 500 |
| Leucovorin Calcium | 63323-0631-10 | FreseniUS Kabi USA, LLC | 10 | 100 |
| Leucovorin Calcium | 63323-0631-50 | FreseniUS Kabi USA, LLC | 50 | 500 |
| Leucovorin Calcium | 63323-0710-50 | FreseniUS Kabi USA, LLC | 1 | 200 |
| Leucovorin Calcium | 63323-0711-00 | FreseniUS Kabi USA, LLC | 1 | 500 |
| Leucovorin Calcium | 67457-0528-10 | Mylan Institutional LLC | 1 | 100 |
| Leucovorin Calcium | 67457-0529-20 | Mylan Institutional LLC | 1 | 200 |
| Leucovorin Calcium | 67457-0530-35 | Mylan Institutional LLC | 1 | 350 |
| Leucovorin Calcium | 68001-0416-36 | BluePoint Laboratories | 1 | 100 |
| Leucovorin Calcium | 68001-0417-37 | BluePoint Laboratories | 1 | 200 |
| Leucovorin Calcium | 68001-0418-38 | BluePoint Laboratories | 1 | 350 |
| Leucovorin Calcium | 68001-0648-36 | BluePoint Laboratories | 1 | 100 |
| Leucovorin Calcium | 68001-0649-37 | BluePoint Laboratories | 1 | 200 |
| Leucovorin Calcium | 68001-0650-38 | BluePoint Laboratories | 1 | 350 |
| Leucovorin Calcium | 68462-0767-35 | Glenmark Pharmaceuticals Inc., Usa | 1 | 350 |
| Leucovorin Calcium | 70436-0116-82 | Slate Run Pharmaceuticals | 10 × 1 | 500 |
| Leucovorin Calcium | 70436-0117-80 | Slate Run Pharmaceuticals | 1 | 100 |
| Leucovorin Calcium | 70436-0118-80 | Slate Run Pharmaceuticals | 1 | 200 |
| Leucovorin Calcium | 70436-0119-80 | Slate Run Pharmaceuticals | 1 | 350 |
| Leucovorin Calcium | 70436-0120-80 | Slate Run Pharmaceuticals | 1 | 500 |
| Leucovorin Calcium | 71288-0160-10 | Meitheal Pharmaceuticals Inc. | 1 | 50 |
| Leucovorin Calcium | 71288-0161-20 | Meitheal Pharmaceuticals Inc. | 1 | 100 |
| Leucovorin Calcium | 71288-0162-30 | Meitheal Pharmaceuticals Inc. | 1 | 200 |
| Leucovorin Calcium | 71288-0163-30 | Meitheal Pharmaceuticals Inc. | 1 | 350 |
| Leucovorin Calcium | 71288-0164-50 | Meitheal Pharmaceuticals Inc. | 1 | 500 |
J0643: common questions
- Is J0643 a CPT code?
- No. J0643 is a HCPCS Level II code, maintained by CMS, that identifies a drug with no specific code of its own. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
- What NDC goes with J0643?
- None is fixed. J0643 is used for drugs that have no specific HCPCS code, so the claim carries the NDC of the drug actually given and its quantity, and payers usually also ask for the drug name and dose. How to find a J-code.
- What is the Medicare payment limit for J0643?
- $0.054 per 1 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.