HCPCS Level II drug code
J0219 — Injection, avalglucosidase alfa-ngpt, 4 mg
In short
J0219 is the HCPCS Level II code for injection, avalglucosidase alfa-ngpt, 4 mg. CMS assigns NDCs for Nexviazyme to it. One billing unit is 4 mg. The Medicare Part B payment limit is $83.816 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS file- Descriptor
- Injection, avalglucosidase alfa-ngpt, 4 mg
- Short descriptor
- Inj aval alfa-nqpt 4mg
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Apr 1, 2022
The billing unit is read from the descriptor. Confirm it against the CMS file before billing.
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. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Units and claim line
Units = dose given ÷ 4 mg. For example, 400 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
NDCs billed under J0219
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J0219 for Nexviazyme. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Nexviazyme | 58468-0426-01 | Genzyme Corporation | 1 | 25 |
J0219: common questions
- Is J0219 a CPT code?
- No. J0219 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
- What NDCs are billed under J0219?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J0219, for Nexviazyme. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for J0219?
- $83.816 per 4 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
- What is one billing unit of J0219?
- One unit of J0219 is 4 mg, as stated in the code's descriptor. Units to report = dose given ÷ 4 mg. J-code billing units.