Inj, cyclosporine 250mg
Products billed under this code include Cyclosporine Injection, Sandimmune.
Payment limit per 250 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 Cyclosporine Injection, Sandimmune.
Payment limit per 250 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 Injection | Padagis US LLC | 00574-0866-10 | 10 | $756.49 |
| Sandimmune | Novartis Pharmaceuticals Corporation | 00078-0109-01 | 10 | $756.49 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $75.649 | $0.00 | 250 MG | Inj, cyclosporine 250mg | v1, posted September 17, 2026 |
| 3Q26 | $75.649 | +$1.447 | 250 MG | Inj, cyclosporine 250mg | v1, posted September 15, 2026 |
| 2Q26 | $74.202 | +$0.521 | 250 MG | Inj, cyclosporine 250mg | v1, posted September 15, 2026 |
| 1Q26 | $73.681 | +$1.10 | 250 MG | Inj, cyclosporine 250mg | v1, posted September 15, 2026 |
| 4Q25 | $72.581 | −$0.107 | 250 MG | Inj, cyclosporine 250mg | v1, posted September 8, 2026 |
| 3Q25 | $72.688 | +$1.287 | 250 MG | Inj, cyclosporine 250mg | v1, posted March 10, 2026 |
| 2Q25 | $71.401 | +$0.041 | 250 MG | Inj, cyclosporine 250mg | v1, posted March 10, 2026 |
| 1Q25 | $71.36 | – | 250 MG | Inj, cyclosporine 250mg | v1, posted December 19, 2025 |
| 1Q23 | $50.115 | −$11.973 | 250 MG | Cyclosporin parenteral 250mg | v1, posted December 6, 2023 |
| 4Q22 | $62.088 | −$0.34 | 250 MG | Cyclosporin parenteral 250mg | v1, posted June 22, 2023 |
| 3Q22 | $62.428 | +$0.073 | 250 MG | Cyclosporin parenteral 250mg | v1, posted June 9, 2023 |
| 2Q22 | $62.355 | +$0.126 | 250 MG | Cyclosporin parenteral 250mg | v1, posted December 14, 2022 |
| 1Q22 | $62.229 | +$0.075 | 250 MG | Cyclosporin parenteral 250mg | v1, posted June 8, 2022 |
| 4Q21 | $62.154 | −$0.481 | 250 MG | Cyclosporin parenteral 250mg | v1, posted June 2, 2022 |
| 3Q21 | $62.635 | +$13.067 | 250 MG | Cyclosporin parenteral 250mg | v1, posted June 2, 2022 |
| 2Q21 | $49.568 | −$1.753 | 250 MG | Cyclosporin parenteral 250mg | v1, posted March 1, 2022 |
| 1Q21 | $51.321 | – | 250 MG | Cyclosporin parenteral 250mg | 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.