CareCost Vials
3 × 1,100 mg
1 billing unit = 10 mg
3,300 mg dose → 330 billing units
J1303 · ravulizumab-cwvz
300 mg and 1,100 mg single-dose vials · JZ on the maintenance doses, JW possible on the loading dose
Calculate this patient's units ↓Maintenance dose for the 60 to under 100 kg adult band (label Table 1); the loading dose and the other six bands are in the table below
This Ultomiris claim carries straight into Claim Check.
Claim Check builds the whole visit — J1303 units, the administration line, the modifiers and the Medicare allowed amount — and prices it against your payer's rate. The estimate turns the same visit into what the patient owes.
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Patient owes, 3,300 mg
Change the payer and the estimate re-prices against that payer's own published rate. The result is a good faith estimate for the patient.
J1303 bills 1 unit per 10 mg: ordered dose ÷ 10 mg = billing units. Ultomiris is not dosed per kilogram; the label's Table 1 sets a loading dose and a maintenance dose for each of seven body-weight bands, so a patient's exact weight at treatment decides which flat dose applies, not a per-kg calculation.
Ultomiris ships in two single-dose vial sizes, 300 mg and 1,100 mg. The 60 to under 100 kg maintenance dose above draws three 1,100 mg vials exactly, so JZ (no drug discarded) is the modifier; the loading dose for this band can leave a small remainder depending on which vial sizes the pharmacy stocks, covered below.
Medicare pays $226.454 per 10 mg unit (ASP+6%) for Q4 2026 — $74,729.82 for the 330-unit
default dose above, plus $67.14 for 96365.
| Body weight band | Loading dose | Maintenance dose | Interval |
|---|---|---|---|
| 40 to under 60 kg | 2,400 mg · 240 units | 3,000 mg · 300 units | Every 8 weeks |
| 60 to under 100 kg (default) | 2,700 mg · 270 units | 3,300 mg · 330 units | Every 8 weeks |
| 100 kg and over | 3,000 mg · 300 units | 3,600 mg · 360 units | Every 8 weeks |
| PNH or aHUS, 30 to under 40 kg | 1,200 mg · 120 units | 2,700 mg · 270 units | Every 8 weeks |
| PNH or aHUS, 20 to under 30 kg | 900 mg · 90 units | 2,100 mg · 210 units | Every 8 weeks |
| PNH or aHUS, 10 to under 20 kg | 600 mg · 60 units | 600 mg · 60 units | Every 4 weeks |
| PNH or aHUS, 5 to under 10 kg | 600 mg · 60 units | 300 mg · 30 units | Every 4 weeks |
The three 40 kg-and-over bands cover all four indications; the four bands under 40 kg are PNH and aHUS
only. Maintenance starts 2 weeks after loading, then repeats on the interval shown. A claim at the 3,300 mg
default bills as J1303 × 330 JZ plus 96365 × 1.
| Code | Description | Units | Modifier |
|---|---|---|---|
| J1303 | Injection, ravulizumab-cwvz, 10 mg | 330 | JZ |
| 96365 | IV infusion, initial, up to 1 hour | 1 | — |
JZ — no discarded drug from a single-dose container. JW — discarded drug from a single-dose container, reported on its own claim line. One of the two is required on every J1303 claim per CMS's July 1, 2023 single-dose container policy.
J1303 × 330 JZ · 96365 × 1. The other two adult maintenance bands (3,000 mg
and 3,600 mg) draw the same way, from ten 300 mg vials and from three 1,100 mg plus one 300 mg vial.
J1303 × 270 · J1303 × 10 JW · 96365 × 1.
96365 covers the initial hour of a therapeutic infusion. Every Ultomiris minimum infusion time runs well under 90 minutes: 0.7 hours at the 3,300 mg maintenance dose (Table 5), 0.6 hours at the 2,700 mg loading dose (Table 4). Bill 96365 alone; 96366 (each additional hour) only applies if the drip actually runs past 90 minutes. The label's required hour of post-infusion monitoring is not infusion time and does not itself justify 96366. 96413 is the chemotherapy family and does not apply to a complement inhibitor.
Ravulizumab levels drop after each of these procedures, so the label requires an extra dose within 4 hours (Table 3): 1,200 to 1,800 mg per plasma exchange or plasmapheresis session, by weight band and by whether the most recent dose was loading or maintenance, and 600 mg after a completed IVIg cycle. It is a separate J1303 claim on the day of the procedure, and it runs even faster (Table 6: 0.17 to 0.5 hours), still billed 96365 alone.
360 units per day is the limit: the top maintenance dose in label Table 1, 3,600 mg for the 100 kg and over band. That claim (360 units) sits right at the edge; a claim line above 360 units for a single day fails the MUE edit. Every other band, adult and pediatric, clears with room to spare, as does a plasma-exchange or IVIg supplemental dose (at most 1,800 mg, 180 units) on its own claim line.
Ultomiris IV ships in two single-dose vial sizes, both a 100 mg/mL solution: 300 mg/3 mL and 1,100 mg/11 mL, diluted 1:1 with 0.9% sodium chloride and infused through a 0.2 or 0.22 micron filter. J1303 (“Injection, ravulizumab-cwvz, 10 mg”) is the HCPCS code for the IV product. Anthem's own quantity-limit table caps it at 3 vials of 1,100 mg or 12 vials of 300 mg per 56 days, and separately lists a 245 mg prefilled cartridge with an on-body injector. That on-body injector is a distinct subcutaneous product this label does not cover; Ultomiris IV bills only from the two vial sizes above.
Soliris (J1300, eculizumab, same maker, unpriced this quarter) is the reference eculizumab; Bkemv (Q5139, Amgen) and Epysqli (Q5141, Samsung Bioepis) are its biosimilars; Piasky (J1307, crovalimab-akkz, Genentech, $551.51 per 10 mg, PNH only) is a separate complement inhibitor, not a ravulizumab biosimilar. Each is an alternative carrying its own J-code. See the FDA Ultomiris label (BLA761108) for full dosing and administration instructions, or the current Medicare rate for J1303 →.
330 billing units. J1303 bills 1 unit per 10 mg, and 3,300 mg is the maintenance dose for the 60 to under 100 kg adult band, drawn from three 1,100 mg vials with nothing discarded.
Adult loading doses run 240 to 300 units and adult maintenance doses run 300 to 360 units, by weight band. The pediatric PNH and aHUS bands, used only under 40 kg, run from 30 to 270 units. The full seven-band table is on this page.
JZ whenever the dose is an exact multiple of the 300 mg or 1,100 mg vials, which is true of every maintenance dose — the 3,300 mg default draws three 1,100 mg vials with nothing left over. JW applies when a pharmacy short on 300 mg vials fills the 2,700 mg loading dose from two 1,100 mg plus two 300 mg vials instead of nine 300 mg vials, discarding 100 mg, 10 units, on its own JW line.
360 units per day for J1303, the top maintenance dose (3,600 mg, the 100 kg and over band). A claim line above 360 units for a single day fails the MUE edit.
Per 10 mg. J1303 is defined as 10 mg per billing unit, so a 3,300 mg dose is 330 units, not 3,300.
Data current: pricing Q4 2026 · payer policies Aug 2026
Sources: CMS ASP pricing files (Q4 2026); FDA-approved prescribing information (ULTOMIRIS label, DailyMed, BLA761108); CMS single-dose container JW/JZ policy (effective July 1, 2023); CMS NCCI MUE table (practitioner services, 2026 Q3); CPT codebook administration-code guidance; 29 commercial payer medical policies in the ravulizumab-cwvz Clearance corpus.
Reviewed September 21, 2026 by Erin Rose, CareCost Estimate founder. Methodology →