SOLIRIS J Code: J1299

Drug & Product Overview

HCPCS Descriptor Injection, eculizumab, 2 mg

HCPCS Added Date April 1, 2025

Manufacturer Alexion Pharmaceuticals

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution, Concentrate

About SOLIRIS

Soliris is a medication aligned to the HCPCS J Code: J1299 for billing, pricing, and reimbursement purposes in the United States. This Immunology medication is administered via the intravenous route and manufactured by Alexion Pharmaceuticals.

According to CMS Drug Use Information: This medication is used to treat a certain blood disorder (paroxysmal nocturnal hemoglobinuria). This disorder can cause a decrease in red blood cells (anemia). This medication helps to block the decrease in red blood cells and can improve the symptoms of anemia (such as tiredness, shortness of breath) and decrease the need for blood transfusions. This medication may also be used to treat a certain immune system disorder (atypical Hemolytic Uremic Syndrome). It helps to prevent blood clots caused by this disorder. Eculizumab is also used to treat a certain muscle condition (generalized Myasthenia Gravis). It may help to improve symptoms of this condition (such as difficulty swallowing, trouble breathing). Eculizumab is also used to treat a certain nervous system disorder that affects the spinal cord and eye nerve (neuromyelitis optica spectrum disorder). It may help to reduce the number of hospital stays due to the disease. This monograph is about the following eculizumab products: eculizumab, eculizumab-aagh, eculizumab-aeeb.

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
25682-0001-01	Soliris	Alexion Pharmaceuticals Inc.	150	300 MG / 30 ML

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SOLIRIS Pricing & Reimbursement

J1299 Private Payer Reimbursement

$45.02 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

Eculizumab Biosimilar Information:

SOLIRIS Approval Date: March 16, 2007

Product Name	HCPCS Code	Active Ingredient	BLA Type
Soliris	J1299	Eculizumab	351(a) Originator Product
Bkemv	Q5152	Eculizumab	351(k) Interchangeable
Epysqli	Q5151	Eculizumab	351(k) Interchangeable

SOLIRIS Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 13.9%

Avg. Days to File 9.0days

Avg. Days to Pay 27.9days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J1299 claims analytics on FocalPoint →

SOLIRIS CPT Administration Codes

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)

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 →

SOLIRIS Medically Unlikely Edits (MUE)

The most billing units of J1299 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 2 mg.

Practitioner Office & Hospital Outpatient

600 units / day

= 1,200 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 →

SOLIRIS 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.

Atypical Hemolytic Uremic Syndrome (aHUS) Generalized Myasthenia Gravis (gMG) Neuromyelitis Optica Spectrum Disorder (NMOSD) Paroxysmal Nocturnal Hemoglobinuria (PNH)

Drug Class

Complement Inhibitor [EPC]Complement Inhibitors [MoA]

Frequently Asked Questions

Is there a manufacturer-published SOLIRIS billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for SOLIRIS.

What are the available SOLIRIS patient assistance programs?

SOLIRIS patient assistance information can be found through Alexion Pharmaceuticals, Inc.. Visit Here →

Where can I find SOLIRIS prescribing information?

SOLIRIS prescribing information can be found at the link below. Visit Here →

Where can I find SOLIRIS side effect information?

Side effect information for SOLIRIS can be found at the following source.

Does billing SOLIRIS require JZ/JW wastage modifiers?

CMS does not include SOLIRIS (J1299) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1299. For more information, visit the link below.

About BuyandBill.com:

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