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Updated July 1st, 2026

CIMZIA J Code: J0717

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

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Q4 2026 Medicare Payment Limit for J0717, effective October 1, 2026: $3.14 per HCPCS billing unit, down 8.8% from $3.444. From CMS's final file.

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Medicare Payment Limit ?
$3.444
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$3.444
/ HCPCS billing unit · APC 1474
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
4
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Drug & Product Overview

HCPCS Descriptor Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
HCPCS Added Date January 1, 2014
Manufacturer UCB Pharma
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Form Injection, Solution | Kit

About CIMZIA

Cimzia is a medication aligned to the HCPCS J Code: J0717 for billing, pricing, and reimbursement purposes in the United States. This Immunology: Anti-TNF medication is administered via the subcutaneous route and manufactured by UCB Pharma.

According to CMS Drug Use Information: This medication is used to reduce pain and swelling due to certain inflammatory conditions (such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, polyarticular juvenile idiopathic arthritis). Some brands may also be used to treat a certain type of spine condition (axial spondyloarthritis) or a certain bowel condition (Crohn's disease). Certolizumab belongs to a class of drugs known as tumor necrosis factor (TNF) blockers. It works by blocking TNF, a substance made by the body that causes inflammation.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
50474-0700-62 Cimzia UCB, Inc. 400 Kit
50474-0710-79 Cimzia UCB, Inc. 400 200 MG / 1 ML
50474-0710-81 Cimzia UCB, Inc. 1200 200 MG / 1 ML
50474-0750-10 Cimzia UCB, Inc. 200 200 MG / 1 ML
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CIMZIA Pricing & Reimbursement

J0717 Private Payer Reimbursement
$3.72 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

CIMZIA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
JW / JZ modifiers apply

CMS has identified Cimzia (J0717) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

CIMZIA Medically Unlikely Edits (MUE)

The most billing units of J0717 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
400 units / day
= 400 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

CIMZIA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Ankylosing Spondylitis Crohn's Disease Non-radiographic Axial Spondyloarthritis Plaque Psoriasis Polyarticular Juvenile Idiopathic Arthritis Psoriatic Arthritis Rheumatoid Arthritis
Drug Class
Tumor Necrosis Factor Blocker [EPC]Tumor Necrosis Factor Receptor Blocking Activity [MoA]

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Frequently Asked Questions

Is there an available Cimzia billing and coding guide?
Our team has not identified a manufacturer-published source of billing and coding information for CIMZIA.
Are there any available Cimzia patient assistance programs?
CIMZIA patient assistance information can be found through UCB. Visit Here →
Where can I find Cimzia prescribing information?
CIMZIA prescribing information can be found at the link below: Visit Here →
Where can I find Cimzia side effect information?
Information regarding CIMZIA's side effects can be found at MedlinePlus Visit Here →
Does billing CIMZIA require JZ/JW wastage modifiers?
CMS has identified CIMZIA(J0717) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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