TROGARZO J Code: J1746
Injection, ibalizumab-uiyk, 10 mg
Q4 2026 Medicare Payment Limit for J1746, effective October 1, 2026: $79.997 per HCPCS billing unit, up 0.6% from $79.512. From CMS's final file.
Drug & Product Overview
About TROGARZO
Trogarzo is a medication aligned to the HCPCS J Code: J1746 for billing, pricing, and reimbursement purposes in the United States. This Anti-HIV medication is administered via the intravenous route and manufactured by Theratechnologies.
According to CMS Drug Use Information: This drug is used with other HIV medications to help control HIV infection. It helps to decrease the amount of HIV in your body so your immune system can work better. This lowers your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life. Ibalizumab belongs to a class of drugs known as monoclonal antibodies. Ibalizumab is not a cure for HIV infection. To decrease your risk of spreading HIV disease to others, continue to take all HIV medications exactly as prescribed by your doctor. Use an effective barrier method (latex or polyurethane condoms/dental dams) during sexual activity as directed by your doctor. Do not share personal items (such as needles/syringes, toothbrushes, and razors) that may have contacted blood or other body fluids. Consult your doctor or pharmacist 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. Showing 1 of 2 NDCs — log in for the full crosswalk.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| 62064-0122-02 | Trogarzo | Theratechnologies Inc. | 40 | 199.5 MG / 1.33 ML |
| •••••-••••-•• Log in to view | TROGARZO | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
TROGARZO Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →TROGARZO 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) |
CMS has identified Trogarzo (J1746) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →
TROGARZO Medically Unlikely Edits (MUE)
The most billing units of J1746 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.
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 →
TROGARZO Clinical Information
Indications and drug classification.
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.
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Frequently Asked Questions
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Does billing TROGARZO require JZ/JW wastage modifiers?
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