Products billed under this code include Cyclosporine, Gengraf, Neoral, Sandimmune.
Payment limit per 100 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 |
|---|---|---|---|---|
| Cyclosporine | Teva Pharmaceuticals USA, Inc. | 00093-9018-65 | 8 | $11.64 |
| Cyclosporine | Teva Pharmaceuticals USA, Inc. | 00093-9019-65 | 15 | $21.825 |
| Cyclosporine | Teva Pharmaceuticals USA, Inc. | 00093-9020-65 | 30 | $43.65 |
| Cyclosporine | Ivax Pharmaceuticals, Inc. | 00172-7313-20 | 50 | $72.75 |
| Cyclosporine | Heritage Pharmaceuticals Inc. | 23155-0839-30 | 30 | $43.65 |
| Cyclosporine | Apotex Corp | 60505-0134-00 | 30 | $43.65 |
| Cyclosporine | Apotex Corp | 60505-4632-03 | 30 | $43.65 |
| Cyclosporine | American Health Packaging | 68084-0921-25 | 30 | $43.65 |
| Gengraf | AbbVie Inc. | 00074-3109-32 | 30 | $43.65 |
| Gengraf | AbbVie Inc. | 00074-7269-50 | 50 | $72.75 |
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Neoral | Novartis Pharmaceuticals Corporation | 00078-0248-15 | 30 | $43.65 |
| Neoral | Novartis Pharmaceuticals Corporation | 00078-0274-22 | 50 | $72.75 |
| Sandimmune | Novartis Pharmaceuticals Corporation | 00078-0110-22 | 50 | $72.75 |
| Sandimmune | Novartis Pharmaceuticals Corporation | 00078-0241-15 | 30 | $43.65 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $1.455 | −$0.104 | 100 MG | Cyclosporine oral 100 mg | v1, posted September 17, 2026 |
| 3Q26 | $1.559 | +$0.131 | 100 MG | Cyclosporine oral 100 mg | v1, posted September 15, 2026 |
| 2Q26 | $1.428 | −$0.382 | 100 MG | Cyclosporine oral 100 mg | v1, posted September 15, 2026 |
| 1Q26 | $1.81 | −$0.229 | 100 MG | Cyclosporine oral 100 mg | v1, posted September 15, 2026 |
| 4Q25 | $2.039 | −$0.03 | 100 MG | Cyclosporine oral 100 mg | v1, posted September 8, 2026 |
| 3Q25 | $2.069 | +$0.046 | 100 MG | Cyclosporine oral 100 mg | v1, posted March 10, 2026 |
| 2Q25 | $2.023 | −$0.176 | 100 MG | Cyclosporine oral 100 mg | v1, posted March 10, 2026 |
| 1Q25 | $2.199 | −$0.188 | 100 MG | Cyclosporine oral 100 mg | v1, posted December 19, 2025 |
| 4Q24 | $2.387 | +$0.196 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 11, 2025 |
| 3Q24 | $2.191 | −$0.104 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 11, 2025 |
| 2Q24 | $2.295 | +$0.031 | 100 MG | Cyclosporine oral 100 mg | v1, posted March 11, 2025 |
| 1Q24 | $2.264 | +$0.057 | 100 MG | Cyclosporine oral 100 mg | v1, posted December 19, 2024 |
| 4Q23 | $2.207 | +$0.448 | 100 MG | Cyclosporine oral 100 mg | v1, posted October 10, 2024 |
| 3Q23 | $1.759 | −$0.509 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 5, 2024 |
| 2Q23 | $2.268 | +$0.168 | 100 MG | Cyclosporine oral 100 mg | v1, posted February 23, 2024 |
| 1Q23 | $2.10 | +$0.277 | 100 MG | Cyclosporine oral 100 mg | v1, posted December 6, 2023 |
| 4Q22 | $1.823 | −$0.308 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 22, 2023 |
| 3Q22 | $2.131 | −$0.098 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 9, 2023 |
| 2Q22 | $2.229 | −$0.197 | 100 MG | Cyclosporine oral 100 mg | v1, posted December 14, 2022 |
| 1Q22 | $2.426 | +$0.011 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 8, 2022 |
| 4Q21 | $2.415 | +$0.287 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 2, 2022 |
| 3Q21 | $2.128 | +$0.464 | 100 MG | Cyclosporine oral 100 mg | v1, posted June 2, 2022 |
| 2Q21 | $1.664 | −$0.054 | 100 MG | Cyclosporine oral 100 mg | v1, posted March 1, 2022 |
| 1Q21 | $1.718 | – | 100 MG | Cyclosporine oral 100 mg | 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.
