NDC - HCPCS Crosswalk

Effective October 1, 2017 through December 31, 2017

The crosswalk is intended to help understand which drug products -identified by NDCs- are assigned to which HCPCS billing codes. The crosswalk is not intended to be a comprehensive list of all NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units.

NDC HCPCS Code Labeler Drug Name Dosage Package Size Package Quantity Billable Units Billable Units / Pkg
13533-636-0290371Grifols USA, LLC.Hep b ig im1 ML1111
13533-636-0390371Grifols USA, LLC.Hep b ig im1 ML0.510.50.5
13533-636-0590371Grifols USA, LLC.Hep b ig im1 ML5155
59730-4202-190371Biotest Pharmaceuticals CorporationHep b ig im1 ML1111
59730-4203-190371Biotest Pharmaceuticals CorporationHep b ig im1 ML5155
13533-618-0290375Grifols USA, LLC.Rabies ig im/sc150 IU2122
13533-618-1090375Grifols USA, LLC.Rabies ig im/sc150 IU1011010
49281-190-2090376sanofi pasteurRabies ig heat treated150 IU2122
0052-0602-0290585Organon USA, Inc.Bcg vaccine percut50 MG1111
0052-0603-0290585Organon USA, Inc.Bcg vaccine percut50 MG1111
0052-0602-0290586Organon USA, Inc.Bcg vaccine intravesical1 EACH1111
0052-0603-0290586Organon USA, Inc.Bcg vaccine intravesical1 EACH1111
0006-4096-0290632Merck Sharp & Dohme Corp.Hepa vaccine adult im1 ML110110
0006-4841-0090632Merck Sharp & Dohme Corp.Hepa vaccine adult im1 ML1111
0006-4841-4190632Merck Sharp & Dohme Corp.Hepa vaccine adult im1 ML110110
58160-826-1190632GlaxoSmithklineHepa vaccine adult im1 ML110110
58160-826-5290632GlaxoSmithklineHepa vaccine adult im1 ML110110
33332-017-0190656SeqirusIIV3 VACC NO PRSV 0.5 ML IM0.5 ML0.510110
0005-1971-0290670Wyeth/Pfizer U.S.PCV13 Vaccine IM0.5 ML0.510110
0005-1971-0590670Wyeth/Pfizer U.S.PCV13 Vaccine IM0.5 ML0.5111
42874-016-1090673Protein SciencesRiv3 vaccine no preserv im0.5 ML0.510110
42874-017-1090673Protein SciencesRiv3 vaccine no preserv im0.5 ML0.510110
49281-250-5190675sanofi pasteurRabies vaccine im1 ML1111
58160-964-1290675GlaxoSmithklineRabies vaccine im1 ML1111
63851-501-0290675GlaxoSmithklineRabies vaccine im1 ML1111
33332-317-0190686ID BiomedicalIIV4 VACC NO PRSV 0.5 ML IM0.5 ML0.510110
33332-417-1090688ID BiomedicalIIV4 VACCINE SPLT 0.5 ML IM0.5 ML511010
13533-131-0190714Grifols USA, LLC.Td vacc no presv 7 yrs+ im0.5 ML0.510110
49281-215-1090714sanofi pasteurTd vacc no presv 7 yrs+ im0.5 ML0.510110
49281-215-1590714sanofi pasteurTd vacc no presv 7 yrs+ im0.5 ML0.510110
49281-400-1090715sanofi pasteurTdap vaccine 7 yrs/> im0.5 ML0.510110
49281-400-1590715sanofi pasteurTdap vaccine 7 yrs/> im0.5 ML0.5515
58160-842-1190715GlaxoSmithklineTdap vaccine 7 yrs/> im0.5 ML0.510110
58160-842-5290715GlaxoSmithklineTdap vaccine 7 yrs/> im0.5 ML0.510110
0006-4739-0090732MerckPPSV23 VACC 2 YRS+ SUBQ/IM0.5 ML2.5155
0006-4837-0290732MerckPPSV23 VACC 2 YRS+ SUBQ/IM0.5 ML0.5111
0006-4837-0390732MerckPPSV23 VACC 2 YRS+ SUBQ/IM0.5 ML0.510110
0006-4943-0090732MerckPPSV23 VACC 2 YRS+ SUBQ/IM0.5 ML0.510110
43528-002-0590739Dynavax Technologies CoHEPB VACC 2 DOSE ADULT IM1 DOSE0.5515
0006-4992-0090740MerckHEPB VACC 3 DOSE IMMUNSUP IM40 MCG1111
58160-821-1190740GlaxoSmithKlineHEPB VACC 3 DOSE IMMUNSUP IM40 MCG1100.55
58160-821-5290740GlaxoSmithKlineHEPB VACC 3 DOSE IMMUNSUP IM40 MCG1100.55
0006-4094-0290743MerckHEPB VACC 2 DOSE ADOLESC IM1 DOSE110110
0006-4094-0990743MerckHEPB VACC 2 DOSE ADOLESC IM1 DOSE1666
0006-4995-0090743MerckHEPB VACC 2 DOSE ADOLESC IM1 DOSE1111
0006-4995-4190743MerckHEPB VACC 2 DOSE ADOLESC IM1 DOSE110110
58160-820-1190743GlaxoSmithKlineHEPB VACC 2 DOSE ADOLESC IM1 DOSE0.510110
0006-4094-0990744MerckHEPB VACC 3 DOSE PED/ADOL IM1 DOSE1666
0006-4981-0090744MerckHEPB VACC 3 DOSE PED/ADOL IM1 DOSE0.510110
0006-4995-4190744MerckHEPB VACC 3 DOSE PED/ADOL IM1 DOSE110110
58160-820-1190744GlaxoSmithKlineHEPB VACC 3 DOSE PED/ADOL IM1 DOSE0.510110
58160-820-5290744GlaxoSmithKlineHEPB VACC 3 DOSE PED/ADOL IM1 DOSE0.510110
0006-4094-0290746MerckHEPB VACCINE 3 DOSE ADULT IM1 EACH110110
0006-4094-0990746MerckHEPB VACCINE 3 DOSE ADULT IM1 DOSE1616
0006-4995-0090746MerckHEPB VACCINE 3 DOSE ADULT IM1 EACH1111
0006-4995-4190746MerckHEPB VACCINE 3 DOSE ADULT IM1 EACH110110
58160-821-1190746GlaxoSmithKlineHEPB VACCINE 3 DOSE ADULT IM1 EACH110110
58160-821-5290746GlaxoSmithKlineHEPB VACCINE 3 DOSE ADULT IM1 EACH110110
0006-4992-0090747MerckHEPB VACC 4 DOSE IMMUNSUP IM40 MCG1111
58160-821-1190747GlaxoSmithKlineHEPB VACC 4 DOSE IMMUNSUP IM40 MCG1100.55
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