Canakinumab injection
Products billed under this code include Ilaris.
Payment limit per 1 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0638
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Ilaris | Novartis Pharmaceuticals Corporation | 00078-0734-61 | 150 | $23,542.95 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $156.953 | +$0.412 | 1 MG | Canakinumab injection | v1, posted September 17, 2026 |
| 3Q26 | $156.541 | +$6.967 | 1 MG | Canakinumab injection | v1, posted September 15, 2026 |
| 2Q26 | $149.574 | +$1.833 | 1 MG | Canakinumab injection | v1, posted September 15, 2026 |
| 1Q26 | $147.741 | +$6.137 | 1 MG | Canakinumab injection | v1, posted September 15, 2026 |
| 4Q25 | $141.604 | +$0.608 | 1 MG | Canakinumab injection | v1, posted September 8, 2026 |
| 3Q25 | $140.996 | +$4.439 | 1 MG | Canakinumab injection | v1, posted March 10, 2026 |
| 2Q25 | $136.557 | +$0.679 | 1 MG | Canakinumab injection | v1, posted March 10, 2026 |
| 1Q25 | $135.878 | +$8.068 | 1 MG | Canakinumab injection | v1, posted December 19, 2025 |
| 4Q24 | $127.81 | +$1.265 | 1 MG | Canakinumab injection | v1, posted June 11, 2025 |
| 3Q24 | $126.545 | +$2.061 | 1 MG | Canakinumab injection | v1, posted June 11, 2025 |
| 2Q24 | $124.484 | +$0.158 | 1 MG | Canakinumab injection | v1, posted March 11, 2025 |
| 1Q24 | $124.326 | +$2.271 | 1 MG | Canakinumab injection | v1, posted December 19, 2024 |
| 4Q23 | $122.055 | +$0.542 | 1 MG | Canakinumab injection | v1, posted October 10, 2024 |
| 3Q23 | $121.513 | +$1.692 | 1 MG | Canakinumab injection | v1, posted June 5, 2024 |
| 2Q23 | $119.821 | +$0.263 | 1 MG | Canakinumab injection | v1, posted February 23, 2024 |
| 1Q23 | $119.558 | +$0.831 | 1 MG | Canakinumab injection | v1, posted December 6, 2023 |
| 4Q22 | $118.727 | +$0.118 | 1 MG | Canakinumab injection | v1, posted June 22, 2023 |
| 3Q22 | $118.609 | +$1.667 | 1 MG | Canakinumab injection | v1, posted June 9, 2023 |
| 2Q22 | $116.942 | +$1.053 | 1 MG | Canakinumab injection | v1, posted December 14, 2022 |
| 1Q22 | $115.889 | +$0.283 | 1 MG | Canakinumab injection | v1, posted June 8, 2022 |
| 4Q21 | $115.606 | +$0.183 | 1 MG | Canakinumab injection | v1, posted June 2, 2022 |
| 3Q21 | $115.423 | +$2.102 | 1 MG | Canakinumab injection | v1, posted June 2, 2022 |
| 2Q21 | $113.321 | +$0.063 | 1 MG | Canakinumab injection | v1, posted March 1, 2022 |
| 1Q21 | $113.258 | – | 1 MG | Canakinumab injection | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021