Home Drug Codes J Codes J0596 · RUCONEST
Updated July 1st, 2026

RUCONEST J Code: J0596

Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units

Login to unlock all benchmarks

Q4 2026 Medicare Payment Limit for J0596, effective October 1, 2026: $37.81 per HCPCS billing unit, down 0.1% from $37.832. From CMS's final file.

?
Medicare Payment Limit ?
$37.832
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$37.832
/ HCPCS billing unit · APC 9445
ASP ?
$•••.••
Login to view
WAC · AWP ?
$•••.••
Login to view
NDCs Crosswalked ?
2
View NDC crosswalk →

Drug & Product Overview

HCPCS Descriptor Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units
HCPCS Added Date January 1, 2016
Manufacturer Pharming Healthcare
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Powder, For Solution

About RUCONEST

Ruconest is a medication aligned to the HCPCS J Code: J0596 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology, it is administered via the intravenous route and manufactured by Pharming Healthcare.

According to CMS Drug Use Information: This medication is used to treat the swelling problems caused by a certain immune disease passed down through families (hereditary angioedema-HAE). HAE is caused by low levels or improper function of a natural substance produced by the body (C1-esterase inhibitor). Symptoms such as rapid swelling of the hands, feet, limbs, face, tongue, or throat can occur. Swelling of the intestinal tract may cause symptoms such as abdominal cramps, diarrhea, or vomiting. Attacks of swelling may occur without reason. However, anxiety, stress, sickness, and surgery may trigger attacks in some people. This medication works by increasing the level of C1-esterase inhibitor to help treat attacks of sudden swelling due to hereditary angioedema.

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 2 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
71274-0350-02 Ruconest Pharming Healthcare Inc. 210 Ruconest Intravenous I njection 2100 U/… Login for More
•••••-••••-•• Log in to view RUCONEST
Login to view 1 more NDC package View pricing, complete NDC-to-HCPCS alignments, and package details.
Login →

RUCONEST Pricing & Reimbursement

J0596 Private Payer Reimbursement
$36.75 / 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 Q3 2026

RUCONEST 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 Ruconest (J0596) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

RUCONEST Medically Unlikely Edits (MUE)

The most billing units of J0596 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 units.

Practitioner Office & Hospital Outpatient
840 units / day
= 8,400 units 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 →

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

RUCONEST 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.

Hereditary Angioedema (HAE)

Login for BuyandBill.com Analytics

Unlock deeper insights with BuyandBill’s Comparative Report!

  • Compare ASP, WAC, and AWP across drugs.
  • Visualize Drug Price Movement Over Time
  • Tailor reports to drug class, manufacturer, or HCPCS Code.
  • Compare Biosimilar and 505(b)(2) products.

Frequently Asked Questions

Is there an available Ruconest billing and coding guide?
Billing and coding information for RUCONEST can be found through Pharming. Visit Here →
Are there any available Ruconest patient assistance programs?
RUCONEST patient assistance information can be found through Pharming. Visit Here →
Where can I find Ruconest prescribing information?
RUCONEST prescribing information can be found at the link below: Visit Here →
Where can I find Ruconest side effect information?
Information regarding RUCONEST's side effects can be found at MedlinePlus Visit Here →
Does billing RUCONEST require JZ/JW wastage modifiers?
CMS has identified RUCONEST(J0596) 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.

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.