Home › NDC Lookup › J-codes › J0217
J0217

J0217 – Injection, velmanase alfa-tycv, 1 mg · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 1 MG $479.191/unit ASP+6%

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J0217 summary

J0217 is a HCPCS Level II J-code used to bill velmanase alfa-tycv, 1 mg, billed per 1 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J0217: Lamzede

Code J0217 Billing unit 1 MG Payment limit $479.191/unit NDC-Crosswalk 1 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ0217
DescriptorInjection, velmanase alfa-tycv, 1 mg
Billing unit1 MG
Payment limit / unit$479.191
Est. ASP / unit$452.067 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20

💊 About Velmanase alfa DRUG GUIDE

Velmanase alfa is used to treat the non-central nervous system (non-CNS) symptoms of alpha-mannosidosis — a rare inherited disease in which the body lacks enough of an enzyme called alpha-mannosidase.

Without enough of this enzyme, sugar-containing waste products build up inside cells and cause damage throughout the body.It is approved for both adults and children with alpha-mannosidosis.

Read the full Velmanase alfa drug guide →
Clinical overview from our editorial drug guide for Velmanase alfa. For billing reference, see the sections above.

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$479.191
Est. ASP / unit
$452.067 est.
Est. after 2% sequester
$469.607
HCPCS dosage
1 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, velmanase alfa-tycv, 1 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeA — Added this year
Effective date2024-01-01
Date added2024-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J0217 = 1 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J0217 WITH EST. MEDICARE PAY

1 NDC map to J0217. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($479.191/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
10122-0180-02 Lamzede Velmanase alfa-tycv 10 mg/1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION Chiesi 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLU... 10 mg/1 10 $4,791.91 — ● Active CMS + PDAC
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period
Total Part B spend
$903.9K
Claims
33
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$27,389.84
Trend by period
Where J0217 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #391 of 824
#386 WILATE J7183 $943.1K #387 AFSTYLA J7210 $916.9K #388 RIMSO-50 J1212 $909.6K #389 EPIXPRESS, PER SQ CM... Q4361 $906.3K #390 REBYOTA J1440 $905.2K #391 LAMZEDE J0217 $903.9K #392 ELELYSO J3060 $871.5K #393 VIVITROL J2315 $866.4K #394 SPEVIGO J1747 $863.1K #395 TEMOZOLOMIDE J8700 $858.1K #396 INTEGRA BMWD** Q4104 $855.9K
Total claims — #730 of 824
#725 XYNTHA SOLOFUSE* J7185 37 #726 PEMETREXED(J9314) J9314 37 #727 TYZAVAN* J3375 35 #728 HEPZATO J9248 35 #729 HYCAMTIN J8705 34 #730 LAMZEDE J0217 33 #731 ZEMDRI J0291 33 #732 DOXY 100* J1271 33 #733 HALOPERIDOL LACTATE J1630 33 #734 APHEXDA J2277 33 #735 STREPTOMYCIN SULFATE J3000 32

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $903.9K — 33 — $27,389.84
2025 (Q1-Q4) $2.54M — 89 — $28,585.07
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📊 What bills under J0217

J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.

NDC products by ingredient
Velmanase alfa-tycv 1
NDC products by labeler
Chiesi USA, Inc. 1

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
1 NDC mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

  • A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
  • Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
  • Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
  • Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
  • The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
  • Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J0217 billing FAQ

What is HCPCS code J0217?
J0217 is a HCPCS Level II J-code used to bill Injection, velmanase alfa-tycv, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0217?
One unit of J0217 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J0217 should I bill?
Divide the dose administered by the code's unit size (1 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J0217?
The Medicare Part B payment limit is $479.191 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $469.607 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0217?
1 NDC currently map to J0217 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J0217 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.