In short

Erzofri is billed under HCPCS J2428 — Injection, paliperidone palmitate extended release (erzofri), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 6 Erzofri NDCs under this code.

J2428 code details

Reference

J2428
Injection, paliperidone palmitate extended release (erzofri), 1 mgBilling unit: 1 mg
Labelers
Luye Pharma USA Ltd

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$15.587
Per1 mg
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Erzofri units and claim line

Enter the dose given to get the J2428 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Erzofri NDCs and billing units

From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.

Erzofri NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
72526-0105-11J2428Luye Pharma USA Ltd0.2539
72526-0106-11J2428Luye Pharma USA Ltd0.578
72526-0107-11J2428Luye Pharma USA Ltd0.75117
72526-0108-11J2428Luye Pharma USA Ltd1156
72526-0109-11J2428Luye Pharma USA Ltd1.5234
72526-0110-11J2428Luye Pharma USA Ltd2.25351

Erzofri: common questions

What is the J-code for Erzofri?
Erzofri is billed under HCPCS J2428 — Injection, paliperidone palmitate extended release (erzofri), 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 6 Erzofri NDCs under this code.
How many J2428 billing units are in a package of Erzofri?
CMS lists 39 to 351 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
Is J2428 a CPT code?
No. J2428 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.

Related

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free Med-Code account to keep looking up NDCs, J-codes and drugs.

Create a free accountLog in