Home › Drug Codes › J Codes › J0644 · Vykoura
Updated October 1st, 2026

Vykoura J Code: J0644

Injection, leucovorin calcium (avyxa), 1 mg

Medicare Payment Limit ?
$2.625
/ HCPCS billing unit
APC Payment Limit ?
$2.625
/ HCPCS billing unit
ASP ?
$2.476
/ HCPCS billing unit
WAC ?
$2.50
/ HCPCS billing unit
AWP ?
$3.00
/ HCPCS billing unit
NDCs Crosswalked ?
3
View NDC crosswalk →

Drug & Product Overview

HCPCS Descriptor Injection, leucovorin calcium (avyxa), 1 mg
HCPCS Added Date October 1, 2026
Manufacturer Avyxa Pharma
Route of Administration Intramuscular, Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About Vykoura

Vykoura is a medication aligned to the HCPCS J Code: J0644 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the intramuscular or intravenous routes and manufactured by Avyxa Pharma.

Manufacturers, reach out to us to add more information.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Package Manufacturer HCPCS Units WAC AWP
83831-0147-05
50 MG / 5 ML Vykoura Intramuscular Injection 50 MG/5ML - 1 VIAL, SINGLE-USE in 1 CARTON (83831-147-05) / 5 mL in 1 VIAL, SINGLE-USE
Avyxa Pharma, LLC 50 $125.00 $2.50 / unit $150.00 $3.00 / unit
83831-0148-35
350 MG / 35 ML Vykoura Intramuscular Injection 350 MG/35ML - 1 VIAL, SINGLE-USE in 1 CARTON (83831-148-35) / 35 mL in 1 VIAL, SINGLE-USE
Avyxa Pharma, LLC 350 $875.00 $2.50 / unit $1,050.00 $3.00 / unit
83831-0149-50
500 MG / 50 ML Vykoura Intramuscular Injection 500 MG/50ML - 1 VIAL, SINGLE-USE in 1 CARTON (83831-149-50) / 50 mL in 1 VIAL, SINGLE-USE
Avyxa Pharma, LLC 500 $1,250.00 $2.50 / unit $1,500.00 $3.00 / unit

Effective 3/16/26 (WAC & AWP)

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Vykoura Pricing & Reimbursement

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HCPCS Units
%
Common:

Estimates only. Payer reimbursement varies by contract, site of care, and sequestration.

Estimated Reimbursement

Leucovorin Calcium 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J0644 Avyxa Pharma Leucovorin Calcium Injection, leucovorin calcium (avyxa), 1 mg

Vykoura 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)
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
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 →

Vykoura 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.

Impaired methotrexate elimination or overdose of folic acid antagonists or dihydrofolate reductase (DHFR) inhibitors Megaloblastic anemia due to folic acid deficiency Metastatic colorectal cancer Rescue after high-dose methotrexate therapy
Drug Class
Folate Analog [EPC]Folic Acid [CS]

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Frequently Asked Questions

Is there an available Vykoura billing and coding guide?
Billing and coding information for Vykoura can be found through Avyxa Pharma. Visit Here →
Are there any available Vykoura patient assistance programs?
Vykoura patient assistance information can be found through Avyxa Pharma. Visit Here →
Where can I find Vykoura prescribing information?
Vykoura prescribing information can be found at the link below. Please reach out to us if you believe this information to be inaccurate or out of date. Visit Here →
Where can I find Vykoura side effect information?
Our team has not yet identified a source of side effects information for Vykoura. Please check back in a few weeks.
Does billing Vykoura require JZ/JW wastage modifiers?
This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers.

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.

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