Inj leucovorin calcium 1 mg
Products billed under this code include Leucovorin Calcium.
Payment limit per 1 MG, by effective quarter, 4Q26 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0643
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 |
|---|---|---|---|---|
| Leucovorin Calcium | Hikma Pharmaceuticals USA Inc. | 00143-9368-01 | 200 | $10.80 |
| Leucovorin Calcium | Hikma Pharmaceuticals USA Inc. | 00143-9552-01 | 350 | $18.90 |
| Leucovorin Calcium | Hikma Pharmaceuticals USA Inc. | 00143-9553-01 | 200 | $10.80 |
| Leucovorin Calcium | Hikma Pharmaceuticals USA Inc. | 00143-9554-01 | 100 | $5.40 |
| Leucovorin Calcium | Hikma Pharmaceuticals USA Inc. | 00143-9555-01 | 50 | $2.70 |
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0813-10 | 500 | $27.00 |
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0814-30 | 100 | $5.40 |
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0815-30 | 200 | $10.80 |
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0816-30 | 350 | $18.90 |
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0816-67 | 350 | $18.90 |
Show all 35 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Leucovorin Calcium | Sagent Pharmaceuticals | 25021-0828-50 | 500 | $27.00 |
| Leucovorin Calcium | FreseniUS Kabi USA, LLC | 63323-0631-10 | 100 | $5.40 |
| Leucovorin Calcium | FreseniUS Kabi USA, LLC | 63323-0631-50 | 500 | $27.00 |
| Leucovorin Calcium | FreseniUS Kabi USA, LLC | 63323-0710-50 | 200 | $10.80 |
| Leucovorin Calcium | FreseniUS Kabi USA, LLC | 63323-0711-00 | 500 | $27.00 |
| Leucovorin Calcium | Mylan Institutional LLC | 67457-0528-10 | 100 | $5.40 |
| Leucovorin Calcium | Mylan Institutional LLC | 67457-0529-20 | 200 | $10.80 |
| Leucovorin Calcium | Mylan Institutional LLC | 67457-0530-35 | 350 | $18.90 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0416-36 | 100 | $5.40 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0417-37 | 200 | $10.80 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0418-38 | 350 | $18.90 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0648-36 | 100 | $5.40 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0649-37 | 200 | $10.80 |
| Leucovorin Calcium | BluePoint Laboratories | 68001-0650-38 | 350 | $18.90 |
| Leucovorin Calcium | Glenmark Pharmaceuticals Inc., Usa | 68462-0767-35 | 350 | $18.90 |
| Leucovorin Calcium | Slate Run Pharmaceuticals | 70436-0116-82 | 500 | $27.00 |
| Leucovorin Calcium | Slate Run Pharmaceuticals | 70436-0117-80 | 100 | $5.40 |
| Leucovorin Calcium | Slate Run Pharmaceuticals | 70436-0118-80 | 200 | $10.80 |
| Leucovorin Calcium | Slate Run Pharmaceuticals | 70436-0119-80 | 350 | $18.90 |
| Leucovorin Calcium | Slate Run Pharmaceuticals | 70436-0120-80 | 500 | $27.00 |
| Leucovorin Calcium | Meitheal Pharmaceuticals Inc. | 71288-0160-10 | 50 | $2.70 |
| Leucovorin Calcium | Meitheal Pharmaceuticals Inc. | 71288-0161-20 | 100 | $5.40 |
| Leucovorin Calcium | Meitheal Pharmaceuticals Inc. | 71288-0162-30 | 200 | $10.80 |
| Leucovorin Calcium | Meitheal Pharmaceuticals Inc. | 71288-0163-30 | 350 | $18.90 |
| Leucovorin Calcium | Meitheal Pharmaceuticals Inc. | 71288-0164-50 | 500 | $27.00 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.054 | – | 1 MG | Inj leucovorin calcium 1 mg | v1, posted September 17, 2026 |
“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