Home › Drug Codes › J Codes › J1305 · Evkeeza
Updated July 1st, 2026

Evkeeza J Code: J1305

Injection, evinacumab-dgnb, 5mg

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Q4 2026 Medicare Payment Limit for J1305, effective October 1, 2026: $202.574 per HCPCS billing unit, up 2.5% from $197.633. From CMS's final file.

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Medicare Payment Limit ?
$197.633
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$197.633
/ HCPCS billing unit · APC 9416
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Injection, evinacumab-dgnb, 5mg
HCPCS Added Date October 1, 2021
Manufacturer Regeneron Pharmaceuticals, Inc
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution, Concentrate

About Evkeeza

Evkeeza is a medication aligned to the HCPCS J Code: J1305 for billing, pricing, and reimbursement purposes in the United States. This Cardiology medication is administered via the intravenous route and manufactured by Regeneron Pharmaceuticals, Inc.

According to CMS Drug Use Information: Evinacumab is used to treat a certain high cholesterol disorder (homozygous familial hypercholesterolemia-HoFH). It is used along with a proper diet and other LDL-lowering treatments (such as "statin" drugs, ezetimibe, LDL apheresis). Evinacumab belongs to a class of drugs known as monoclonal antibodies. It works by blocking a certain protein that stops your body from properly breaking down cholesterol. This effect helps decrease "bad cholesterol" and fats (such as LDL, triglycerides). In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
61755-0010-01 Evkeeza Regeneron Pharmaceuticals, Inc. 240 1200 MG / 8 ML
61755-0013-01 Evkeeza Regeneron Pharmaceuticals, Inc. 69 345 MG / 2.3 ML
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Evkeeza Pricing & Reimbursement

J1305 Private Payer Reimbursement
$197.13 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Evkeeza CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Evkeeza (J1305) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

Evkeeza Medically Unlikely Edits (MUE)

The most billing units of J1305 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mg.

Practitioner Office & Hospital Outpatient
480 units / day
= 2,400 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

Evkeeza Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Homozygous Familial Hypercholesterolemia (HoFH)
Drug Class
Angiopoietin-like 3 Inhibitor [EPC]Angiopoietin-like 3 Inhibitors [MoA]

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Frequently Asked Questions

Is there an available Evkeeza billing and coding guide?
Billing and coding information for Evkeeza can be found through Regeneron Pharmaceuticals, Inc. Visit Here →
Are there any available Evkeeza patient assistance programs?
Evkeeza patient assistance information can be found through Regeneron Pharmaceuticals, Inc. Visit Here →
Where can I find Evkeeza prescribing information?
Evkeeza prescribing information can be found at the link below: Visit Here →
Where can I find Evkeeza side effect information?
Information regarding Evkeeza's side effects can be found at MedlinePlus Visit Here →
Does billing Evkeeza require JZ/JW wastage modifiers?
CMS has identified Evkeeza(J1305) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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