Home › Drug Codes › J Codes › J1203 · POMBILITI
Updated October 1st, 2026

POMBILITI J Code: J1203

Injection, cipaglucosidase alfa-atga, 5 mg

Login to unlock all benchmarks
Medicare Payment Limit ?
$96.491
up 0.2% since Q3 2026
/ HCPCS billing unitQ3 2026: $96.302
APC Payment Limit ?
$96.491
up 0.2% since Q3 2026
/ HCPCS billing unitQ3 2026: $96.302
ASP ?
$•••.••
Login to view
WAC · AWP ?
$•••.••
Login to view
NDCs Crosswalked ?
3
View NDC crosswalk →

Drug & Product Overview

HCPCS Descriptor Injection, cipaglucosidase alfa-atga, 5 mg
HCPCS Added Date April 1, 2024
Manufacturer Amicus Therapeutics
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Powder, Lyophilized, For Solution

About POMBILITI

Pombiliti is a medication aligned to the HCPCS J Code: J1203 for billing, pricing, and reimbursement purposes in the United States. This Genetic Disorder medication is administered via the intravenous route and manufactured by Amicus Therapeutics.

According to CMS Drug Use Information: Cipaglucosidase alfa is used in combination with another medication (miglustat) to treat a certain inherited condition (Pompe disease). It works by breaking down a certain substance (glycogen) that builds up in the body due to this condition. Decreasing glycogen in the body can help improve symptoms of Pompe disease such as muscle weakness, heart problems, and breathing problems. This medication must be used with miglustat because it helps cipaglucosidase alfa stay active in the blood which helps it work better.

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. Showing 1 of 3 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
71904-0200-01 Pombiliti Atga AMICUS THERAPEUTICS US, LLC 21 105 MG
•••••-••••-•• Log in to view POMBILITI
POMBILITI
Login to view 2 more NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.
Login →

POMBILITI Pricing & Reimbursement

J1203 Private Payer Reimbursement
$91.58 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →
UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q4 2026

POMBILITI 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
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415 Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

POMBILITI Medically Unlikely Edits (MUE)

The most billing units of J1203 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mg.

Practitioner Office & Hospital Outpatient
630 units / day
= 3,150 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.

POMBILITI 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.

late-onset Pompe disease (lysosomal acid alpha-glucosidase [GAA] deficiency)
Drug Class
Hydrolytic Lysosomal Glycogen-specific Enzyme [EPC]alpha-Glucosidases [CS]

Try Pro free for 7 daysUpgrade to ProAdd Analytics and full history with ProComparative Report

Compare POMBILITI with alternatives

  • POMBILITI J1203
  • NEXVIAZYME J0219
  • OPFOLDA J1202
  • LUMIZYME J0221

ASP, the Medicare payment limit, WAC and AWP for all 4 drugs on one timeline, with 10+ years of monthly history.

Card required · cancel anytime

Compare alternatives →

Frequently Asked Questions

Is a Pombiliti billing and coding guide available?
Our team has not identified a manufacturer-published source of billing and coding information for POMBILITI.
Is Pombiliti patient assistance information available?
POMBILITI patient assistance information can be found through Amicus Therapeutics. Visit Here →
Where can I find Pombiliti prescribing information?
POMBILITI prescribing information can be found at the link below: Visit Here →
Where can I find Pombiliti side effect information?
Information regarding POMBILITI's potential side effects can be found at MedlinePlus Visit Here →
Does billing POMBILITI require JZ/JW wastage modifiers?
CMS does not include POMBILITI (J1203) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1203. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.

Related Drug Codes

Explore billing, coding, and pricing for drugs related to POMBILITI.

J0219NEXVIAZYMEInjection, avalglucosidase alfa-ngpt, 4 mgSanofiAdded April 1, 2022J1202OPFOLDAMiglustat, oral, 65 mgAmicus TherapeuticsAdded April 1, 2024J0221LUMIZYMEInjection, alglucosidase alfa, (lumizyme), 10 mgSanofiAdded January 1, 2012C9172BEQVEZInjection, fidanacogene elaparvovec-dzkt, per therapeutic dosePfizerAdded October 1, 2024C9309ItvismaInjection, onasemnogene abeparvovec-brve, per treatmentNovartis Gene TherapiesAdded April 1, 2026C9311WainuaInjection, eplontersen, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)AstraZenecaAdded October 1, 2026J0222ONPATTROInjection, patisiran, 0.1 mgAlnylam PharmaceuticalsAdded October 1, 2019J0223GIVLAARIInjection, givosiran, 0.5 mgAlnylam PharmaceuticalsAdded July 1, 2020J0224OXLUMOInjection, lumasiran, 0.5 mgAlnylam PharmaceuticalsAdded July 1, 2021J0225AmvuttraInjection, vutrisiran, 1 mgAlnylam PharmaceuticalsAdded January 1, 2023

Free account · J1203

POMBILITI pricing you won’t find in public files

Create a free account to search every drug code, then try Pro free for 7 days to see ASP, WAC and AWP.

  • Free: payment limits for every code
  • 7-day Pro trial: ASP, WAC and AWP

Unlock with a 7-day Pro trial

ASP
Locked
WAC per billing unit
Locked
AWP per billing unit
Locked

10+

years of ASP, WAC and AWP price history

14,000+

NDC-to-HCPCS alignments built in-house, nearly twice the public crosswalks

Create your free account

  1. 1 Personal Info
  2. 2 About You
  3. 3 Credentials

Please use your company email. Personal addresses like Gmail or Yahoo aren’t accepted.

Personal Info

Already have an account? Log In