HCPCS drug code · CMS crosswalk
Gamifant J-Code / HCPCS Code
In short
Gamifant is billed under HCPCS J9210 — Injection, emapalumab-lzsg, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 3 Gamifant NDCs under this code.
Reference
- J9210
- Injection, emapalumab-lzsg, 1 mgBilling unit: 1 mg
- Labelers
- Swedish Orphan Biovitrum AB (PuBL)
Medicare Part B payment limit
CMS ASP filePayment limit per unit$391.861
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
Gamifant units and claim line
Enter the dose given to get the J9210 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Gamifant 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.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 66658-0501-01 | J9210 | Swedish Orphan Biovitrum AB (PuBL) | 2 | 10 |
| 66658-0505-01 | J9210 | Swedish Orphan Biovitrum AB (PuBL) | 10 | 50 |
| 66658-0510-01 | J9210 | Swedish Orphan Biovitrum AB (PuBL) | 20 | 100 |
Gamifant: common questions
- What is the J-code for Gamifant?
- Gamifant is billed under HCPCS J9210 — Injection, emapalumab-lzsg, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 3 Gamifant NDCs under this code.
- How many J9210 billing units are in a package of Gamifant?
- CMS lists 10 to 100 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 J9210 a CPT code?
- No. J9210 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.