Inj, tofidence, 1 mg
Products billed under this code include Tofidence.
Payment limit per 1 MG, by effective quarter, 1Q25 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under Q5133
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 |
|---|---|---|---|---|
| Tofidence | Organon LLC | 64406-0022-01 | 200 | $941.20 |
| Tofidence | Organon LLC | 64406-0023-01 | 400 | $1,882.40 |
| Tofidence | Organon LLC | 64406-0024-01 | 80 | $376.48 |
| Tofidence | Organon LLC | 78206-0200-01 | 80 | $376.48 |
| Tofidence | Organon LLC | 78206-0201-01 | 200 | $941.20 |
| Tofidence | Organon LLC | 78206-0202-01 | 400 | $1,882.40 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $4.706 | −$0.307 | 1 MG | Inj, tofidence, 1 mg | v1, posted September 17, 2026 |
| 3Q26 | $5.013 | −$0.246 | 1 MG | Inj, tofidence, 1 mg | v1, posted September 15, 2026 |
| 2Q26 | $5.259 | −$0.326 | 1 MG | Inj, tofidence, 1 mg | v1, posted September 15, 2026 |
| 1Q26 | $5.585 | +$0.049 | 1 MG | Inj, tofidence, 1 mg | v1, posted September 15, 2026 |
| 4Q25 | $5.536 | −$0.258 | 1 MG | Inj, tofidence, 1 mg | v1, posted September 8, 2026 |
| 3Q25 | $5.794 | −$0.177 | 1 MG | Inj, tofidence, 1 mg | v1, posted March 10, 2026 |
| 2Q25 | $5.971 | −$0.025 | 1 MG | Inj, tofidence, 1 mg | v1, posted March 10, 2026 |
| 1Q25 | $5.996 | – | 1 MG | Inj, tofidence, 1 mg | v1, posted December 19, 2025 |
“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