HCPCS drug code · CMS crosswalk
Syfovre J-Code / HCPCS Code
In short
Syfovre is billed under HCPCS J2781 — Injection, pegcetacoplan, intravitreal, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Syfovre NDCs under this code.
Reference
- J2781
- Injection, pegcetacoplan, intravitreal, 1 mgBilling unit: 1 mg
- Labelers
- Apellis Pharmaceuticals, Inc.
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: AMP-based payment limit. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Syfovre units and claim line
Enter the dose given to get the J2781 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Syfovre 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 |
|---|---|---|---|---|
| 73606-0020-01 | J2781 | Apellis Pharmaceuticals, Inc. | 0.1 | 15 |
| 73606-0020-02 | J2781 | Apellis Pharmaceuticals, Inc. | 0.1 | 15 |
Syfovre: common questions
- What is the J-code for Syfovre?
- Syfovre is billed under HCPCS J2781 — Injection, pegcetacoplan, intravitreal, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 2 Syfovre NDCs under this code.
- How many J2781 billing units are in a package of Syfovre?
- CMS lists 15 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 J2781 a CPT code?
- No. J2781 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.