ULTOMIRIS J Code: J1303

Drug & Product Overview

HCPCS Descriptor Injection, ravulizumab-cwvz, 10 mg

HCPCS Added Date October 1, 2019

Manufacturer Alexion Pharmaceuticals

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Solution, Concentrate

About ULTOMIRIS

Ultomiris is a medication aligned to the HCPCS J Code: J1303 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology drug administered via the intravenous route and manufactured by Alexion Pharmaceuticals.

According to CMS Drug Use Information: Ravulizumab is used to treat a certain blood disorder (paroxysmal nocturnal hemoglobinuria). This disorder causes your body's immune system to destroy red blood cells, which results in anemia. It works by helping block your body's destruction of red blood cells. This effect helps lessen symptoms of anemia (such as tiredness, shortness of breath), and may reduce 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. Ravulizumab may be used to treat a certain muscle condition (generalized myasthenia gravis). It may help to improve symptoms of muscle weakness. This medication 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. Ravulizumab belongs to a class of medications known as monoclonal antibodies.

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
25682-0025-01	Ultomiris	Alexion Pharmaceuticals Inc.	30	300 MG / 3 ML
25682-0028-01	Ultomiris	Alexion Pharmaceuticals Inc.	110	1100 MG / 11 ML

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ULTOMIRIS Pricing & Reimbursement

J1303 Private Payer Reimbursement

$224.68 / 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

ULTOMIRIS Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 18.36%

Avg. Days to File 10.7days

Avg. Days to Pay 27.6days

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

Explore J1303 claims analytics on FocalPoint →

ULTOMIRIS 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)

JW / JZ modifiers apply

CMS has identified Ultomiris (J1303) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ULTOMIRIS Medically Unlikely Edits (MUE)

The most billing units of J1303 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient

360 units / day

= 3,600 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 →

ULTOMIRIS 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 Generalized Myasthenia Gravis Neuromyelitis Optica Spectrum Disorder Paroxysmal Nocturnal Hemoglobinuria

Drug Class

Complement Inhibitor [EPC]Complement Inhibitors [MoA]

Frequently Asked Questions

Is there an available Ultomiris billing and coding guide?

Billing and coding information for ULTOMIRIS can be found through Alexion Pharmaceuticals. Visit Here →

Are there any available Ultomiris patient assistance programs?

ULTOMIRIS patient assistance information can be found through Alexion Pharmaceuticals. Visit Here →

Where can I find Ultomiris prescribing information?

ULTOMIRIS prescribing information can be found at the link below: Visit Here →

Where can I find Ultomiris side effect information?

Information regarding ULTOMIRIS's side effects can be found at MedlinePlus Visit Here →

Does billing ULTOMIRIS require JZ/JW wastage modifiers?

CMS has identified ULTOMIRIS(J1303) 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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