HCPCS drug code · CMS crosswalk
Lumizyme J-Code / HCPCS Code
In short
Lumizyme is billed under HCPCS J0221 — Injection, alglucosidase alfa, (lumizyme), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Lumizyme NDC under this code.
Reference
- J0221
- Injection, alglucosidase alfa, (lumizyme), 10 mgBilling unit: 10 mg
- Labelers
- Genzyme Corporation
Medicare Part B payment limit
CMS ASP filePayment limit per unit$211.056
Per10 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
Lumizyme units and claim line
Enter the dose given to get the J0221 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Lumizyme 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 |
|---|---|---|---|---|
| 58468-0160-01 | J0221 | Genzyme Corporation | 1 | 5 |
Lumizyme: common questions
- What is the J-code for Lumizyme?
- Lumizyme is billed under HCPCS J0221 — Injection, alglucosidase alfa, (lumizyme), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 1 Lumizyme NDC under this code.
- How many J0221 billing units are in a package of Lumizyme?
- CMS lists 5 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is J0221 a CPT code?
- No. J0221 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.