HCPCS code J2428 — Inj, erzofri, 1 mg. Status: Active. Effective Apr 1, 2025. Source: CMS HCPCS Level II.

J2428

Active

Inj, erzofri, 1 mg

Injection, paliperidone palmitate extended release (erzofri), 1 mg

Category: Drugs
Section: J-codes: Drugs Administered Other Than Oral Method
Effective: Apr 1, 2025
Code type: alphanumeric
OPPS Status: K — Non-pass-through drugs and biologicals
OPPS APC: 2072

MUE — Medically Unlikely Edits

Maximum units of J2428 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.

Service Type Max Units / Day
DME Supplier 351
Outpatient Hospital 351
Practitioner Services 351

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
72526-0105-11 Erzofri
72526-0106-11 Erzofri
72526-0107-11 Erzofri
72526-0108-11 Erzofri
72526-0109-11 Erzofri
72526-0110-11 Erzofri

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2025-Q2
    Inj, erzofri, 1 mg