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HCPCS J0643 · Level II · Part B drug

HCPCS J0643: Injection, leucovorin calcium, not otherwise specified, 1 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J0643

Billing unit
1 MG
Inj leucovorin calcium 1 mg
ASP payment limit
$0.054
October 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
not in Addendum B
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J0643 is the Level II code for Injection, leucovorin calcium, not otherwise specified, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.054 per billing unit. With a 1 mg billing unit, a single administration can be hundreds of units; the unit count on the claim must equal the milligrams given, and rounding rules for partial units follow the contractor's guidance. The ASP crosswalk maps 35 NDCs to it, sold as Leucovorin Calcium by Hikma Pharmaceuticals USA Inc., Sagent Pharmaceuticals, FreseniUS Kabi USA, LLC. No current Billing and Coding Article lists J0643, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J0643 at $0.054 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%. Beneficiary coinsurance is 20%.

ASP payment limits for J0643
QuarterPayment limitPerCoinsurance
October 2026$0.0541 MG20%
July 2026n/a1 MG—
CMS note: Added October 2026

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 35 NDCs from 8 labelers to J0643. Report the NDC in the claim's drug segment and bill the number of J0643 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J0643
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9368-01Leucovorin CalciumHikma Pharmaceuticals USA Inc.1 × 1200
00143-9552-01Leucovorin CalciumHikma Pharmaceuticals USA Inc.1 × 1350
00143-9553-01Leucovorin CalciumHikma Pharmaceuticals USA Inc.1 × 1200
00143-9554-01Leucovorin CalciumHikma Pharmaceuticals USA Inc.1 × 1100
00143-9555-01Leucovorin CalciumHikma Pharmaceuticals USA Inc.1 × 150
25021-0813-10Leucovorin CalciumSagent Pharmaceuticals1 × 10500
25021-0814-30Leucovorin CalciumSagent Pharmaceuticals1 × 1100
25021-0815-30Leucovorin CalciumSagent Pharmaceuticals1 × 1200
25021-0816-30Leucovorin CalciumSagent Pharmaceuticals1 × 1350
25021-0816-67Leucovorin CalciumSagent Pharmaceuticals1 × 1350
25021-0828-50Leucovorin CalciumSagent Pharmaceuticals1 × 1500
63323-0631-10Leucovorin CalciumFreseniUS Kabi USA, LLC10 × 1100
63323-0631-50Leucovorin CalciumFreseniUS Kabi USA, LLC50 × 1500
63323-0710-50Leucovorin CalciumFreseniUS Kabi USA, LLC1 × 1200
63323-0711-00Leucovorin CalciumFreseniUS Kabi USA, LLC1 × 1500
67457-0528-10Leucovorin CalciumMylan Institutional LLC1 × 1100
67457-0529-20Leucovorin CalciumMylan Institutional LLC1 × 1200
67457-0530-35Leucovorin CalciumMylan Institutional LLC1 × 1350
68001-0416-36Leucovorin CalciumBluePoint Laboratories1 × 1100
68001-0417-37Leucovorin CalciumBluePoint Laboratories1 × 1200
68001-0418-38Leucovorin CalciumBluePoint Laboratories1 × 1350
68001-0648-36Leucovorin CalciumBluePoint Laboratories1 × 1100
68001-0649-37Leucovorin CalciumBluePoint Laboratories1 × 1200
68001-0650-38Leucovorin CalciumBluePoint Laboratories1 × 1350
68462-0767-35Leucovorin CalciumGlenmark Pharmaceuticals Inc., Usa1 × 1350
70436-0116-82Leucovorin CalciumSlate Run Pharmaceuticals1 × 10500
70436-0117-80Leucovorin CalciumSlate Run Pharmaceuticals1 × 1100
70436-0118-80Leucovorin CalciumSlate Run Pharmaceuticals1 × 1200
70436-0119-80Leucovorin CalciumSlate Run Pharmaceuticals1 × 1350
70436-0120-80Leucovorin CalciumSlate Run Pharmaceuticals1 × 1500
71288-0160-10Leucovorin CalciumMeitheal Pharmaceuticals Inc.1 × 150
71288-0161-20Leucovorin CalciumMeitheal Pharmaceuticals Inc.1 × 1100
71288-0162-30Leucovorin CalciumMeitheal Pharmaceuticals Inc.1 × 1200
71288-0163-30Leucovorin CalciumMeitheal Pharmaceuticals Inc.1 × 1350
71288-0164-50Leucovorin CalciumMeitheal Pharmaceuticals Inc.1 × 1500

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J0643 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J0643 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J0643 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J0643 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Common denials for J0643 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J0643 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J0643

What does HCPCS code J0643 describe?

J0643 is defined by CMS as "Injection, leucovorin calcium, not otherwise specified, 1 mg". Each billing unit represents 1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J0643 in October 2026?

The ASP-based payment limit is $0.054 per 1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules.

Which NDCs map to J0643?

The October 2026 ASP crosswalk lists 35 NDCs from 8 labelers: Leucovorin Calcium (Hikma Pharmaceuticals USA Inc.); Leucovorin Calcium (Sagent Pharmaceuticals); Leucovorin Calcium (FreseniUS Kabi USA, LLC); Leucovorin Calcium (Mylan Institutional LLC). For example NDC 00143-9368-01 is a 1 package equal to 200 billing units. The crosswalk's billing-units-per-package figure converts each package into J0643 units.

Does J0643 have NCCI bundling edits?

No active practitioner PTP pairs list J0643 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.