ELAPRASE J Code: J1743

Drug & Product Overview

HCPCS Descriptor Injection, idursulfase, 1 mg

HCPCS Added Date January 1, 2008

Manufacturer Takeda Pharmaceuticals

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Form Solution, Concentrate

About ELAPRASE

Elaprase is a medication aligned to the HCPCS J Code: J1743 for billing, pricing, and reimbursement purposes in the United States. This Enzyme Replacement Therapy medication is administered via the intravenous route and manufactured by Takeda Pharmaceuticals.

According to CMS Drug Use Information: Idursulfase is used to treat a certain inherited condition (mucopolysaccharidosis type II-Hunter syndrome) that causes a buildup of a certain substance (glycosaminoglycan-GAG) in the body. Idursulfase works by breaking down GAGs in the body. This medication may improve how far you can walk.

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
54092-0700-01	Elaprase	Takeda Pharmaceuticals America, Inc.	6	6 MG / 3 ML

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ELAPRASE Pricing & Reimbursement

J1743 Private Payer Reimbursement

$558.17 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

ELAPRASE CPT Administration Codes

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

JW / JZ modifiers apply

CMS has identified Elaprase (J1743) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ELAPRASE Medically Unlikely Edits (MUE)

The most billing units of J1743 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

66 units / day

= 66 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 →

ELAPRASE 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.

Hunter syndrome (Mucopolysaccharidosis II, MPS II)

Drug Class

Hydrolytic Lysosomal Glycosaminoglycan-specific Enzyme [EPC]alpha-Glucosidases [CS]

Frequently Asked Questions

Is there an available Elaprase billing and coding guide?

Billing and coding information for ELAPRASE can be found through Takeda. Visit Here →

Are there any available Elaprase patient assistance programs?

ELAPRASE patient assistance information can be found through Takeda. Visit Here →

Where can I find Elaprase prescribing information?

ELAPRASE prescribing information can be found at the link below: Visit Here →

Where can I find Elaprase side effect information?

Our team has not yet identified a source of side effects information for ELAPRASE. Please check back in a few weeks.

Does billing ELAPRASE require JZ/JW wastage modifiers?

CMS has identified ELAPRASE(J1743) 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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