Home › Drug Codes › J Codes › J2428 · ERZOFRI
Updated July 1st, 2026

ERZOFRI J Code: J2428

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

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Q4 2026 Medicare Payment Limit for J2428, effective October 1, 2026: $15.587 per HCPCS billing unit, down 1.8% from $15.873. From CMS's final file.

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Medicare Payment Limit ?
$15.873
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$15.873
/ HCPCS billing unit · APC 2072
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
6
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Drug & Product Overview

HCPCS Descriptor Injection, paliperidone palmitate extended release (erzofri), 1 mg
HCPCS Added Date April 1, 2025
Manufacturer Shandong Luye Pharmaceuticals
Route of Administration Intramuscular
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About ERZOFRI

Erzofri is a medication aligned to the HCPCS J Code: J2428 for billing, pricing, and reimbursement purposes in the United States. It is a Psychiatric drug administered via the intramuscular route and manufactured by Shandong Luye Pharmaceuticals.

According to CMS Drug Use Information: This medication is used to treat certain mental/mood disorders (such as schizophrenia, schizoaffective disorder). Paliperidone belongs to a class of drugs known as atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.

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. Showing 5 of 6 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
72526-0105-11 Erzofri extended-release Shandong Luye Pharmaceutical Co., Ltd. 39 39 MG / 0.25 ML
72526-0106-11 Erzofri extended-release Shandong Luye Pharmaceutical Co., Ltd. 78 78 MG / 0.5 ML
72526-0107-11 Erzofri extended-release Shandong Luye Pharmaceutical Co., Ltd. 117 117 MG / 0.75 ML
72526-0108-11 Erzofri extended-release Shandong Luye Pharmaceutical Co., Ltd. 156 156 MG / 1 ML
72526-0109-11 Erzofri extended-release Shandong Luye Pharmaceutical Co., Ltd. 234 234 MG / 1.5 ML
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ERZOFRI Pricing & Reimbursement

J2428 Private Payer Reimbursement
$15.59 / 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

Paliperidone Palmitate Extended Release 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J2426 Janssen Paliperidone Palmitate Extended Release Injection, paliperidone palmitate extended release (invega sustenna), 1 mg
J2428 Shandong Luye Pharmaceuticals Paliperidone Palmitate Extended Release Injection, paliperidone palmitate extended release (erzofri), 1 mg

ERZOFRI 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
Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

ERZOFRI Medically Unlikely Edits (MUE)

The most billing units of J2428 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
351 units / day
= 351 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.

ERZOFRI 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.

Schizoaffective disorder Schizophrenia
Drug Class
Atypical Antipsychotic [EPC]

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Frequently Asked Questions

Is there a manufacturer-published ERZOFRI billing and coding guide?
Our team has not identified a manufacturer-published source of billing and coding information for ERZOFRI.
What are the available ERZOFRI patient assistance programs?
ERZOFRI patient assistance information can be found through Shandong Luye Pharmaceutical. Visit Here →
Where can I find ERZOFRI prescribing information?
ERZOFRI prescribing information can be found at the link below. Visit Here →
Where can I find ERZOFRI side effect information?
Side effect information for ERZOFRI can be found at the following source.
Does billing ERZOFRI require JZ/JW wastage modifiers?
CMS does not include ERZOFRI (J2428) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2428. For more information, visit the link below.

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