In short

Zemaira is billed under HCPCS J0256 — Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 3 Zemaira NDCs under this code.

J0256 code details

Reference

J0256
Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mgBilling unit: 10 mg
Labelers
CSL Behring L.L.C.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$5.077
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

Zemaira units and claim line

Enter the dose given to get the J0256 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Zemaira 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.

Zemaira NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
00053-7201-02J0256CSL Behring L.L.C.10.1
00053-7202-02J0256CSL Behring L.L.C.10.1
00053-7203-02J0256CSL Behring L.L.C.10.1

Zemaira: common questions

What is the J-code for Zemaira?
Zemaira is billed under HCPCS J0256 — Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 3 Zemaira NDCs under this code.
How many J0256 billing units are in a package of Zemaira?
CMS lists 0.1 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 J0256 a CPT code?
No. J0256 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.

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