Omalizumab injection
Products billed under this code include Xolair.
Payment limit per 5 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 this code include Xolair.
Payment limit per 5 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.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 |
|---|---|---|---|---|
| Xolair | Genentech, Inc. | 50242-0040-62 | 30 | $1,370.61 |
| Xolair | Genentech, Inc. | 50242-0214-01 | 15 | $685.305 |
| Xolair | Genentech, Inc. | 50242-0214-03 | 15 | $685.305 |
| Xolair | Genentech, Inc. | 50242-0214-55 | 15 | $685.305 |
| Xolair | Genentech, Inc. | 50242-0215-01 | 30 | $1,370.61 |
| Xolair | Genentech, Inc. | 50242-0215-03 | 30 | $1,370.61 |
| Xolair | Genentech, Inc. | 50242-0215-55 | 30 | $1,370.61 |
| Xolair | Genentech, Inc. | 50242-0227-01 | 60 | $2,741.22 |
| Xolair | Genentech, Inc. | 50242-0227-55 | 60 | $2,741.22 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $45.687 | −$0.901 | 5 MG | Omalizumab injection | v1, posted September 17, 2026 |
| 3Q26 | $46.588 | +$4.765 | 5 MG | Omalizumab injection | v1, posted September 15, 2026 |
| 2Q26 | $41.823 | −$3.676 | 5 MG | Omalizumab injection | v1, posted September 15, 2026 |
| 1Q26 | $45.499 | +$0.903 | 5 MG | Omalizumab injection | v1, posted September 15, 2026 |
| 4Q25 | $44.596 | +$4.033 | 5 MG | Omalizumab injection | v1, posted September 8, 2026 |
| 3Q25 | $40.563 | +$0.446 | 5 MG | Omalizumab injection | v1, posted March 10, 2026 |
| 2Q25 | $40.117 | +$2.362 | 5 MG | Omalizumab injection | v1, posted March 10, 2026 |
| 1Q25 | $37.755 | −$0.538 | 5 MG | Omalizumab injection | v1, posted December 19, 2025 |
| 4Q24 | $38.293 | −$0.033 | 5 MG | Omalizumab injection | v1, posted June 11, 2025 |
| 3Q24 | $38.326 | +$1.52 | 5 MG | Omalizumab injection | v1, posted June 11, 2025 |
| 2Q24 | $36.806 | −$2.653 | 5 MG | Omalizumab injection | v1, posted March 11, 2025 |
| 1Q24 | $39.459 | +$0.369 | 5 MG | Omalizumab injection | v1, posted December 19, 2024 |
| 4Q23 | $39.09 | −$0.293 | 5 MG | Omalizumab injection | v1, posted October 10, 2024 |
| 3Q23 | $39.383 | +$1.467 | 5 MG | Omalizumab injection | v1, posted June 5, 2024 |
| 2Q23 | $37.916 | −$0.28 | 5 MG | Omalizumab injection | v1, posted February 23, 2024 |
| 1Q23 | $38.196 | −$0.456 | 5 MG | Omalizumab injection | v1, posted December 6, 2023 |
| 4Q22 | $38.652 | +$0.535 | 5 MG | Omalizumab injection | v1, posted June 22, 2023 |
| 3Q22 | $38.117 | +$0.849 | 5 MG | Omalizumab injection | v1, posted June 9, 2023 |
| 2Q22 | $37.268 | −$0.239 | 5 MG | Omalizumab injection | v1, posted December 14, 2022 |
| 1Q22 | $37.507 | −$0.161 | 5 MG | Omalizumab injection | v1, posted June 8, 2022 |
| 4Q21 | $37.668 | −$0.222 | 5 MG | Omalizumab injection | v1, posted June 2, 2022 |
| 3Q21 | $37.89 | +$0.725 | 5 MG | Omalizumab injection | v1, posted June 2, 2022 |
| 2Q21 | $37.165 | −$0.251 | 5 MG | Omalizumab injection | v1, posted March 1, 2022 |
| 1Q21 | $37.416 | – | 5 MG | Omalizumab 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.